Postexercise Electrocardiogram in Screening for Latent Ischemic Heart Disease

Double Master's exercise tests were performed in the course of general or periodic examinations on 1,375 patients without angina pectoris. These patients were either asymptomatic or had nonspecific chest pain, and patients with angina pectoris or previous myocardial infarction were specifically excluded. Initial tests were negative in 1,269 (92 percent) and positive in 106 (8 percent). Follow-up information (average duration 30 months) was obtained from clinical reexamination in 833 patients. Of 763 patients with negative tests, 740 (97 percent) were well at last follow-up, 16 (2 percent) had developed clinical signs of ischemic heart disease and seven (1 percent) were dead. Of 70 patients with positive exercise tests, only 21 (30 percent) were living and well at last follow-up, while 42 (60 percent) had signs of ischemic heart disease and seven (10 percent) were dead. It appeared that the double Master's exercise test may have been a valuable adjunct in screening essentially asymptomatic patients for ischemic heart disease. A negative exercise test in such patients seemed to be associated with low rate of development of clinical ischemic heart disease in immediate future months, while a positive exercise test frequently seemed to presage clinical disease in this group of patients.