Exercise-induced intermittent angina and ST-segment elevation in Prinzmetal's angina

Scardi, S; Pivotti, F; Pandullo, Claudio; Ceschia, Giuliano; Salvi, Alessandro

doi:10.1093/oxfordjournals.eurheartj.a062379

Cited by 1 publication

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“…Exercise induced ST-segment elevation in V 1 and V 2 leads, but not the aVR lead, is significant for diagnosis of CAD [1,79,86,87]. ST-segment elevation signifies severe transmural ischemia caused by multi-vessel CAD, or coronary artery spasm (Prinzmetal's angina) [29,[88][89][90]. In contrast to ST-segment depression, ST-segment elevation does identify the ischemic region; further, the territory of ischemia is greater in patients with exerciseinduced ST-segment elevation than with ST-segment depression…”

Section: St-segment Elevationmentioning

confidence: 99%

The diagnostic value of exercise stress testing for cardiovascular disease is more than just st segment changes: A review

Sharif¹,

Alway²

2016

J Integr Cardiol

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Purpose: The objectives of this review were to: (1) identify the acute cardiovascular responses to aerobic exercise used in an exercise stress test (EST), (2) identify when and how to best conduct an EST including the stopping point, (3) identify conditions that would preclude an EST, (4) define the limiting signs and symptoms associated with an EST (5), discuss what data are needed as part of an EST and how to interpret EST data. Methods:We identify the cardiovascular responses to an EST and when an EST should or should not be used. Finally we analyze the components of an EST and potential sensitivities, significances and predictability of the changes in the outcome data that will provide diagnosis overt cardiovascular disease, and for purposes of exercise prescription and evaluation of rehabilitation effects in cardiac patients.Results: Although most of the focus for performing an EST traditionally has been on the diagnostic value to identify ST-segment abnormalities, an EST provides other valuable diagnostic and prognostic data including maximal oxygen consumption (predicted or measured), exercise capacity and fatigability, blood pressure and heart rate responses to exercise and recovery. Conclusions:This review identifies the most recent standards, and guidelines of EST, which include the acute physiological response of the cardiovascular system to aerobic exercise, the use of EST in evaluation of coronary artery disease, an updated diagnostic and prognostic variables of EST, and reporting of EST.

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