Comparison of exercise tests and 24-hour ambulatory electrocardiographic monitoring in detection of ST-T changes.

Forty-seven subjects over the age of 40 years, with atypical praecordial symptoms and a normal resting electrocardiogram, were evaluated for early detection of ischaemic heart disease using the single two-step exercise test, the multistage bicycle ergometric test, and continuous 24-hour ambulatory electrocardiographic monitoring. In 40 of the 47 subjects the results of both the ergometric test and the 24-hour monitoring were similar; in i9 of them both tests were negative and in 2I subjects ST-T changes were detected by both ergo-metry and 24-hour monitoring. A discrepancy between the two tests was found in only 7 subjects, 4 of whom showed ST-T changes on ergometry only and 3 on monitoring only. The single two-step test was positive in only iI of the 47 patients and is regarded as much less sensitive than the other two methods. A good correlation was found between the multistage bicycle exercise test and 24-hour monitoring, and the combined application of both tests will increase the yield of detection of ST-T changes in patients with suspected ischaemic heart disease.

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