Electrocardiographic Changes During Attacks of Angina Pectoris

Feil, Harold; Siegel, Michael

doi:10.1097/00000441-192802000-00010

Cited by 146 publications

(14 citation statements)

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“…Although exercise electrocardiography (ECG) has been utilized to detect coronary artery disease (CAD) for 50 years, uncertain ties and controversies persist regarding this method [1][2][3]. Test results are confounded by arbitrary criteria and difficulty in interpreta tion.…”

Section: Introductionmentioning

confidence: 99%

The Value of Chest Pain during the Exercise Tolerance Test in Predicting Coronary Artery Disease

Richardson

Holly

Amsterdam³

et al. 1992

Cardiology

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The predictive power of 10 common exercise test parameters compared with coronary angiography was studied. Only the exercise electrocardiogram (EXECG), maximal rate pressure product (MAXRPP), and exercise chest pain (EXCP) contributed unique predictive information with the emergence of two interactions involving EXCP (EXCP•EXECG and EXCP· MAXRPP). In conclusion: (1) EXCP appears to be a more serious finding only in those higher risk individuals with either a positive EXECG or lower MAXRPP; (2) EXCP and its interactions may help discriminate between anginal and nonanginal, exertional chest pain, and (3) the contradictory results found when EXCP was allowed to interact may explain conflicting results in previous multivariate models regarding the predictive significance of EXCP.

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Section: Introductionmentioning

confidence: 99%

The Value of Chest Pain during the Exercise Tolerance Test in Predicting Coronary Artery Disease

Richardson

Holly

Amsterdam³

et al. 1992

Cardiology

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“…The initial stimulus for CST was relatively crude – patients were required to perform sit-ups while their symptoms and vital signs were monitored (Feil H 1928). This was followed by individualization of the exercise-load to meet each patient’s capacity (Wood et al 1950), the development of the nine-inch step (Missal 1938), the use of the treadmill or bicycle (Northridge et al 1990) and standardized exercise protocols like the Bruce protocol (Bruce et al 1963; Taylor et al 1955; Taylor et al 1963).…”

Section: Development and Refinement Of Stimuli For Cardiac Stress Tesmentioning

confidence: 99%

The early identification of psychosis: can lessons be learnt from cardiac stress testing?

2015

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Psychotic disorders including schizophrenia are amongst the most debilitating psychiatric disorders. There is an urgent need to develop methods to identify individuals at risk with greater precision and as early as possible. At present, a prerequisite for a diagnosis of schizophrenia is the occurrence of a psychotic episode. Therefore, attempting to detect schizophrenia on the basis of psychosis is analogous to diagnosing coronary artery disease (CAD) after the occurrence of a myocardial infarction (MI). The introduction of cardiac stress testing (CST) has revolutionized the detection of CAD and the prevention and management of angina and MI. In this paper we attempt to apply lessons learnt from cardiac stress testing to the early detection of psychosis by proposing the development of an analogous psychosis stress test. We discuss in detail the various parameters of a proposed psychosis stress test including the choice of a suitable psychological or psychopharmacological “stressor”, target population, outcome measures, safety of the approach and the necessary evolution of test to become clinically informative. The history of evolution of CST may guide the development of a similar approach for the detection and management of psychotic disorders. The initial development of a test to unmask latent risk for schizophrenia will require the selection of a suitable and safe stimulus and the development of outcome measures as a prelude to testing in populations with a range of risk to determine predictive value. The use of cardiac stress testing in coronary artery disease offers the intriguing possibility that a similar approach may be applied to the detection and management of schizophrenia.

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“…The electrocardiogram (ECG) was recognized as a tool for detection of CAD as early as 1928 with the observation of exercise-induced ST-and T-wave changes in patients with chronic stable angina (5). The development of a standardized exercise stress protocol for evaluation of functional capacity and ''circulatory efficiency'' followed in the subsequent year (6).…”

Section: Exercise-ecg Stress Testmentioning

confidence: 99%

Nuclear Cardiac Stress Testing in the Era of Molecular Medicine

Vesely¹,

Dilsizian²

2008

J Nucl Med

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The objective of cardiac stress testing is to detect coronary artery disease (CAD) and to prevent future adverse events, such as myocardial infarction or death. The progression from electrocardiographically based stress testing to current SPECT and PET technologies has brought improvements in diagnostic efficacy and resolution. Myocardial perfusion imaging facilitates management of CAD in elective and acute settings by providing valuable diagnostic and prognostic information. Hybrid PET/CT and SPECT/CT systems impart complementary information of coronary anatomy and its physiologic significance on blood flow reserve. In the current era, diagnosis and treatment of cardiovascular disease is increasingly defined by underlying molecular and genomic aberrations rather than by clinical signs and symptoms alone. Nuclear imaging is uniquely primed to exploit the targeting of expressed cell-surface molecules and intracellular processes of cardiovascular disease and to foster the development of innovative therapeutic interventions in the future.

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Electrocardiographic Changes During Attacks of Angina Pectoris

Cited by 146 publications

References 0 publications

The Value of Chest Pain during the Exercise Tolerance Test in Predicting Coronary Artery Disease

The Value of Chest Pain during the Exercise Tolerance Test in Predicting Coronary Artery Disease

The early identification of psychosis: can lessons be learnt from cardiac stress testing?

Nuclear Cardiac Stress Testing in the Era of Molecular Medicine

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