If the test is positive, i.e. there is significant evidence of cardiac ischaemia, then this allows one to assess the probability that the patient has ischaemic heart disease. About 75% of patients with ischaemic heart disease have a positive exercise test. There is a false positive rate of 5%, i.e. 5% of patient's with a positive test will have normal arteries.
The predictive value of the test increases with the more positive the exercise test result. If there is sloping of the ST segment then a down sloping ST segment is far more significant than an upsloping ST segment.
Reciprocal ST depression induced by exercise is usually associated with extensive Q wave infarctions and persistent occlusion of the artery related to the infarct. This phenomenom does not seem to be an indicator for reversible ischaemia and should not be used as a non-invasive marker of multivessel disease in the assessment of requirements for further investigation soon after an acute MI.
For more detailed information and ECG examples then click here
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.