| Sub-title | |
| Authors | C J Magri N Gatt A Fenech N Calleja |
| Abstract | Aims: To determine how many patients with a positive stress test actually proved to have coronary artery disease on coronary angiography and to identify situations where exercise stress test has a low sensitivity. Methods: The subjects chosen for this study were patients who performed exercise stress test during 2003, as provided from the records at Cardiac Lab. Case notes of patients were then reviewed retrospectively. Any relevant past medical history, stress test result, coronary angiogram and/or MIBI report, relevant admissions or consequent discharges were noted, together with the management of patients with positive coronary angiogram. Coronary angiogram was taken as the gold standard investigation for identification of coronary artery disease. Results: Out of approximately 1500 patients who performed a stress test during 2003, 1148 case notes could be traced. The population studied was predominantly male (64.3%). Average age was 54.8 years. 238 patients were diagnosed with a positive stress teSt Of these, 187 proceeded to coronary angiography and 73% (136) had a positive result. A lower incidence of risk factors was reported in the group with false positive stress tests. Out of the patients who were diagnosed as having a normal exercise stress test, 52 also had a coronary angiogram done; 69% (36) resulted positive. Of these 13 proceeded to PCI and 8 proceeded to CABG. In patients with false negative stress tests, 28% had a past history of MI, PCI or CABG; 19% presented with acute coronary syndrome and 11% with established myocardial infarction. 135 patients had an equivocal stress test; 35 proceeded to angiography of which 57% were positive. Conclusions: Analysis of risk factors as well as past history of ischaemic heart disease is necessary for improved interpretation of stress tests and earlier referral of the cardiac patient to coronary angiography. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 18 Supplement |
| Page | |
| Date | 01/12/2006 |
| Link to journal | |
| Key words | audit, exercise, stress tests |