Imran Khan, Adnan Khan, Rizwana Arif, Hammad Azam, Hina Rashid.
Exercise tolerance test as screening tool for suspected myocardial ischemia.
Rawal Med J Jan ;38(2):117-20.

Background: The cardiac related signs and symptoms like chest pain, arrhythmias originate diagnostic uncertainty which can lead to many unnecessary admissions. Screenings of people who are at high risk for developing coronary heart disease are essential. This study aims to identify the common indications for ETT and to determine the frequency of IHD among subjects who presented with chest pain. Methods: It was a cross-sectional study; the data was taken from the Exercise Tolerance Test (ETT) Unit at Department of Cardiology Rehman Medical Institute, Peshawar using Bruce protocol. Result: Out of the total (n=200) patients, there were 116 (58%) males and 84 (42%) females who presented in the cardiology department for ETT during the study period. The common indications for ETT were; chest pain 124 (62%) and shortness of breath 24(12%), while 24(12%) and 28(14%) of subject were referred for general checkup and nonspecific symptoms respectively. Majority of subject 120(60%) had normal sinus rhythm during resting ECG. Regarding post ECG 100(50%) have no ST changes. The most common risk factors were smoking, hypertension, obesity and diabetes. Majority of subjects 148(74%) were test negative for ischemic heart disease and angina, 36(18%) have test positive for ischemia and angina and only 16(8%) ETT were negative for ischemic heart disease and positive for arrhythmias. Conclusions: In conclusion, we recommend using ETT as a screening tool in patients who present with sign and symptoms simulating angina, this prevent unnecessary hospital admissions.

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