Recovery positive exercise stress test: an indication for coronary artery disease

The significance of ST depression occurring during exercise treadmill stress test has been well established. However, at times there may be no ST segment changes during exercise with changes occurring during the recovery phase. Out of the 1234 patients who underwent exercise stress test, 17 patients had ST segment changes confined to recovery phase. Coronary angiography performed in these 17 patients showed 11 patients had significant coronary artery disease (CAD), with nine patients having triple vessel disease and 2 having double vessel disease. Analysis showed there was no significant difference in the two groups of CAD and no CAD with respect to sex ratio, mean duration of exercise, maximal heart rate and double product achieved.

Although, patients with recovery positive stress test may have normal coronary angiography, a large number of patients (64.7%) in our study had significant CAD. Hence, such patients should be subjected to another noninvasive test such as thallium perfusion scan or coronary angiography.