The predictive value of a strongly positive stress test in patients with minimal symptoms

David S. Blumenthal, James L Weiss, E. David Mellits, Gary Gerstenblith

Research output: Contribution to journalArticle

Abstract

The ability of a strongly positive stress test to predict left main coronary artery disease in people with suspected coronary artery disease but with minimal or no angina was investigated in 40 such patients. Nine had a history of myocardial infarction but no angina. Thirty-one had mild angina or a history of mild angina. The stress electrocardiograms were analyzed according to criteria known to be associated with left main coronary artery disease in moderately or severely symptomatic patients; (1) early S-T segment changes (stage I or II of exercise), (2) 2 mm or more S-T segment depression, (3) downsloping S-T segments, (4) associated exercise-induced hypotension, (5) prolonged S-T segment changes after the test (≥8 minutes) and (6) anterior and inferior S-T segment depression. The prevalence of left main coronary artery disease was 35 percent and that of any severe coronary artery disease 75 percent. The criterion of anterior and inferior electrocardiographic changes with exercise was most predictive of left main coronary artery disease (P <0.01 by χ2). Exercise electrocardiography is useful in the prediction of left main or other severe coronary artery disease even when performed in patients who have minimal angina or in those who are asymptomatic after myocardial infarction.

Original languageEnglish (US)
Pages (from-to)1005-1010
Number of pages6
JournalAmerican Journal of Medicine
Volume70
Issue number5
DOIs
StatePublished - 1981
Externally publishedYes

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Exercise Test
Coronary Artery Disease
Exercise
Electrocardiography
Myocardial Infarction
Controlled Hypotension

ASJC Scopus subject areas

  • Nursing(all)

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The predictive value of a strongly positive stress test in patients with minimal symptoms. / Blumenthal, David S.; Weiss, James L; Mellits, E. David; Gerstenblith, Gary.

In: American Journal of Medicine, Vol. 70, No. 5, 1981, p. 1005-1010.

Research output: Contribution to journalArticle

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