Diagnostic and functional exercise testing: test selection and interpretation

Exercise stress tests are useful in many areas of medical practice and research. The results extend the clinical significance of information obtained from other sources (ie, detailed history, thorough physical examination, resting electrocardiogram, chest radiograph, and basic laboratory analyses) and serve as a diagnostic, prognostic, and therapeutic guide. Leg or arm ergometry is commonly used to assess a patient's functional status, diagnose relative myocardial ischemia, and investigate physiologic mechanisms of cardiac symptoms. The responses may also be used to determine the effects of interventions such as coronary artery bypass surgery, percutaneous transluminal coronary angioplasty, medications, or exercise training.