[The value of exercise tests in the diagnosis of ischemic heart disease]

New knowledges of contemporary cardiology have created possibilities for critically reevaluation of current criteria in exercise testing and have shown its new diagnostic and prognostic value. A multifactorial approach to exercise testing includes an analysis of ECG criteria and hemodynamic parameters obtained during exercise testing. This approach increases the value of stress testing in diagnosis, assessment of the severity and prognosis of coronary artery disease. The inclination toward arrhythmias, detection of asymptomatic ischemia and early detection of a dysfunction of the left ventricle have been emphasized. The indications for use and termination of exercise testing absolute and relative contraindications for exercise testing are critically discussed. The sensitivity of exercise testing is 60 to 80 percent and specificity level ranges between 85 to 90 percent. The incidence of serious complications is decreased about 50 percent by a careful screening of patients and appropriate safety level.