Exercise stress testing in a community clinic: experience with 38,970 patients

Exercise testing is an important diagnostic and prognostic procedure in the assessment of patients with ischemic heart disease, arrhythmia and hypertension.

The purpose of this study was to determine the reasons for referral and the safety of exercise testing in the community.

The records of 38,970 patients who underwent stress testing in a community clinic were reviewed retrospectively.

The majority of the tests (24,153) were performed by family physicians and the rest by cardiologists. The mean age of the patients was 54 +/- 12 years (range 12-81 years). Sixty-eight percent were males, and the majority were referred by family physicians (50%). The main reason for referral was chest pain evaluation (59%); none of the patients died during testing, two patients sustained myocardial infarction during the recovery period and ischemia was detected in 14% of patients. Persistent tachyarrythmia was observed in five patients (0.01%). A vasovagal reaction was observed during the recovery period in 36 patients (0.1%).

This report emphasizes that stress tests can be performed safely in a community clinic with a very low rate of complications by family physicians or cardiologists.