December 4, 2008 – The electrocardiogram (ECG) may not be the best tool for predicting the onset of heart problems in people with suspected angina pectoris. Routine physical assessment and patient history would be equally effective, according to a study published in the British Medical Journal1.
British researchers followed 8,176 patients with chest pain who were seeing a heart problem for the first time. Since these patients were prone to angina, they all had a resting ECG and 4,873 of them also had a stress ECG.
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A doctor may recommend that you have a ECG if you show signs ofarrhythmia, of palpitations, ofdizziness, of excessive fatigue orangina3. |
During the follow-up of almost two and a half years, the EKG tests2 at rest did not predict more cases of cardiovascular disease than routine examinations. The stress ECG prediction rate was 5% higher than that of the resting ECG. During this period, 47% of fatal or major cardiovascular disorders appeared in patients with normal exercise ECG results.
The EKG is a useful and inexpensive test, says Dr.r Anil Nigam, cardiologist at the Montreal Heart Institute. “Although it is not a great predictive tool, we will not change our practice,” says Dr Nigam. “It is an interesting diagnostic tool to determine, for example, if a patient needs to be hospitalized or if he needs certain medications. However, better tools will need to be developed to predict a patient’s risk of severe heart disease in the short or long term. “
Emmanuelle Bergeron – PasseportSanté.net
1. Sekhri N, Feder GS, et al. Incremental prognostic value of the exercise electrocardiogram in the initial assessment of patients with suspected angina: cohort study, BMJ. 2008 Nov 13; 337: a2240.
2. Patients who see a doctor for chest pain are usually required to have a resting and exerting EKG on a treadmill. This test helps target the exact cause of chest pain, especially if cardiovascular disease is suspected.
3. Heart and Stroke Foundation. To find out more about the electrocardiogram: www.fmcoeur.com [Consulté le 4 décembre 2008].
