Document Detail

The detection of asympatomatic coronary artery disease.
MedLine Citation:
PMID:  857728     Owner:  NLM     Status:  MEDLINE    
In summary, near-maximal or maximal exercise testing has a sensitivity of approximately 60% and a specificity of approximately 90% for coronary atherosclerotic heart disease. When screening asympatomatic men with exercise testing, an abnormal response identifies a group of men at very high risk for coronary artery disease. However, the predictive value limitations are obvious and the false-positive problem must be realized. At present, there is no second line of noninvasive studies that can separate an exercise-test false positive from a true positive with certainty. Risk-factor consideration may help separate them; The sensitivity limitations of exercise testing must be especially considered when evaluating people at high risk for CAD. An abnormal test response does not absolutely predict the presence of CAD and a normal response does not rule out its possibility. In appropriate instances where coronary angiography can be performed at minimal risk and when it is justified for reasons of public safety or individual well-being, this procedure can give a reasonably definitive answer. Creation of iatrogenic "cardiac cripples" can be the most common complication of screening tests and should be avoided. Therefore, good clinical judgment needs to be used in conjunction with any screening test.
V F Froelicher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annual review of medicine     Volume:  28     ISSN:  0066-4219     ISO Abbreviation:  Annu. Rev. Med.     Publication Date:  1977  
Date Detail:
Created Date:  1977-06-22     Completed Date:  1977-06-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2985151R     Medline TA:  Annu Rev Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-12     Citation Subset:  IM    
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MeSH Terms
Age Factors
Coronary Disease / diagnosis*
Exercise Test
False Negative Reactions
False Positive Reactions

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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