Exercise Stress Testing to Screen for Coronary Artery Disease in Asymptomatic Persons

Exercise testing has proven value for the diagnosis of cardiac disorders in symptomatic patients and for the objective measurement of functional capacity. Use of exercise tests to screen for cardiac disease in asymptomatic persons remains controversial because of the low prevalence of disease in the population tested, the different characteristics of the test in asymptomatic persons, and the uncertain value of the information generated. This paper addresses the use of exercise testing to screen for coronary artery disease in asymptomatic persons. The principles underlying the use of screening tests will first be presented. The epidemiological evidence concerning screening exercise tests will then be reviewed, followed by the data concerning the prognosis and treatment of asymptomatic coronary disease. Finally, possible indications for screening exercise tests in specific occupations will be addressed.