Exercise Testing And Risk Assessment

With the development of advanced imaging modalities, the regular exercise electro-cardiogram (ECG) test has come to be regarded by some as passé. In large part, this is because of the low sensitivity and specificity for the diagnosis of coronary artery disease (CAD). With newer methods of interpretation, however, exercise testing remains a powerful and inexpensive prognostic tool. The use of the exercise test has important implications for risk stratification as a part of prevention strategies and for after myocardial infarction (MI) management. This chapter focuses primarily on the prognostic implications of exercise testing using cardiovascular events and mortality as endpoints. It examines all aspects of the exercise test, including functional capacity, heart rate (HR) changes during exercise, blood pressure (BP) response, and more-recent methods of computerized interpretation of the exercise ECG.