Exercise testing in selected patient groups. Women, the elderly, and the asymptomatic.

Abstract

Exercise testing for coronary artery disease (CAD) has been validated primarily for middle-aged men. For women and the elderly, full assessment of individual risk and estimation of the pre-test likelihood of CAD is important before deciding to perform an exercise study. Negative electrocardiographic (ECG) findings with an exercise test in women and the elderly are predictive of good prognosis and low risk of cardiovascular events. Positive ECG findings may be falsely positive, and additional testing, nuclear or echocardiographic imaging, or coronary angiography may be indicated. Consensus guidelines are not yet available for testing in asymptomatic patients with exercise, and individual management decisions are still required.