Key result
Exercise ECG in asymptomatic individuals yields ~35% false-positive ST responses, risking iatrogenic psychological harm.
Why the study?
The limitations and value of exercise ECG testing in diagnosing CAD and assessing functional capacity in asymptomatic individuals remain debated.
High false-positive rates warrant caution against asymptomatic exercise ECG screening; leaves open optimal noninvasive risk assessment strategies.
Recently, the limitations of the exercise (stress) ECG test in the diagnosis of coronary artery disease (CAD) have been overemphasized, particularly in the asymptomatic population.1-3Nevertheless, many physicians who have extensive and clinical investigative experience with the exercise ECG test are fully convinced that the test provides great value in the diagnosis of CAD and in the assessment of functional capacity.4.5 Some physicians who are skeptical about the value of the exercise ECG test for the screening of presumably healthy individuals are constantly disturbed by the high incidence (35% to 36%) of "false"-positive tests—ST segment responses.6.7They criticize that a false-positive exercise ECG test frequently leads to psychological trauma (production of "cardiac neurosis") for the individual who has no CAD. It should be emphasized, however, that psychological trauma is usually physician-induced and by no means test-induced. The psychological reaction will largely depend on the physician's approach to a given individual
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E.K. Chung (1980) conducted an editorial in Coronary artery disease. Exercise ECG testing was evaluated. Exercise ECG testing in asymptomatic individuals yields a high incidence (35% to 36%) of false-positive ST segment responses, which may lead to physician-induced psychological trauma.
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