Value of Double Standard Two-Step Test in Detecting Coronary Disease
Progress rept. 1 Jul 1961-30 Jun 1962
WALTER REED ARMY INST OF RESEARCH WASHINGTON DC
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The value of the postexercise electrocardiogram in detecting an evaluating the changes occurring in the electrocardiogram following exercise, and its use in identifying individuals suspected of having coronary insufficiency has been the basis of a follow-up study of 1000 selected individuals in the military service having postexercise electrocardiograms at Walter Reed General Hospital between 1943 and 1950. In an initial classification of the postexercise electrocardiogram by Masters criteria, 746 had a normal response or negative test, and 254 had an abnormal response or positive test. The instances of fatal or nonfatal occlusion were significantly higher in those having an abnormal response than in those having a normal response. A second evaluation was made of those showing abnormal response in the electrocardiograms and these were further broken down by the character of the changes in the postexercise electrocardiograms. The best correlation was obtained in those individuals who showed ischemic ST-flattening and depression as the significant postexercise abnormality. Individuals showing J-junction type of depression had a higher morbidity and mortality rate from coronary disease than hose with isolated T-wave change or normal response.
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