What is the significance of positive treadmill stress testing results in asymptomatic persons without known coronary artery disease (CAD)?

Updated: Nov 21, 2018
  • Author: David Akinpelu, MD, FACP; Chief Editor: Eric H Yang, MD  more...
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Answer

A positive exercise test result is a better predictor of the subsequent development of angina than the occurrence of a major event is. Even when subsequent angina is considered an event, a minority of patients with a positive test result experience cardiac events. Unfortunately, patients with positive test results may be labeled as being at risk.

For example, general population screening programs attempting to identify young patients with early disease are limited, in that severe CAD requiring intervention in asymptomatic patients is exceedingly rare. Although the physical risks of exercise testing are negligible, false-positive test results may (1) engender inappropriate anxiety, (2) have serious adverse consequences related to work and insurance coverage, and (3) lead to complications from further diagnostic testing. For these reasons, exercise testing in healthy, asymptomatic persons is not recommended.


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