Effect of β-blockade on the interpretation of the exercise ECG: ST level versus Δ STHR index

Herbert, William G.; Dubach, Paul; Lehmann, Kenneth G.; Froelicher, Victor F.

doi:10.1016/0002-8703(91)90463-r

Cited by 29 publications

(1 citation statement)

References 13 publications

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“…Causes of false negative test include use of β-blockers, which may reduce the diagnostic or prognostic value of exercise testing because of inadequate heart rate response, but the decision to remove a patient from β-blocker therapy for exercise testing should be made on an individual basis and should be done carefully to avoid a potential hemodynamic “rebound” effect, which can lead to accelerated angina or hypertension. 28 , 30 Acute administration of nitrates can attenuate the angina and ST depression associated with myocardial ischemia. Atrial repolarization waves are opposite in direction to P waves and may extend into the ST segment and T wave.…”

Section: Interpretation Of the Electrocardiogram (Ecg)mentioning

confidence: 99%

Overview of Exercise Stress Testing

Kharabsheh

Al-Sugair

Al-Buraiki

et al. 2006

Annals of Saudi Medicine

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Exercise stress testing is a non-invasive, safe and affordable screening test for coronary artery disease (CAD), provided there is careful patient selection for better predictive value. Patients at moderate risk for CAD are best served with this kind of screening, with the exception of females during their reproductive period, when a high incidence of false positive results has been reported. Patients with a high pretest probability for CAD should undergo stress testing combined with cardiac imaging or cardiac catheterization directly. Data from the test, other than ECG changes, should be taken into consideration when interpreting the exercise stress test since it has a strong prognostic value, i.e. workload, heart rate rise and recovery and blood pressure changes. Only a low-level exercise stress test can be performed early post myocardial infarction (first week), and a full exercise test should be delayed 4 to 6 weeks post uncomplicated myocardial infarction. The ECG interpretation with myocardial perfusion imaging follows the same criteria, but the sensitivity is much lower and the specificity is high enough to overrule the imaging part.

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Section: Interpretation Of the Electrocardiogram (Ecg)mentioning

confidence: 99%