The Master two-step test is a standardized exercise that permits the making of an electrocardiogram immediately after the activity terminates. The main criterion of the result is the behavior of the S-T segment of the tracing; depression of more than 0.5 mm. in any lead is considered a positive result. The test was applied to 186 patients known to have either angina pectoris or a healed myocardial infarction. By the criterion of ischemic S-T segment depression alone the test was positive in 61.3%; when Master's other criteria were also imposed, the test was positive in 81.7%. The test was applied further to 108 normal persons. By the criterion of ischemic S-T segment depression alone the test was negative in all; when Master's other criteria were also imposed, the test was positive in 19.4%. While a negative result does not exclude coronary insufficiency, a positive one strengthens the diagnosis of suspected coronary disease. Although the only conclusive evidence of coronary insufficiency is believed to be ischemic S-T segment depression, fewer cases escaped detection when all of Master's criteria were utilized. When sound clinical judgment is employed in conjunction with the test, overdiagnosis is infrequent.
Russek HI. MASTER TWO-STEP TEST IN CORONARY ARTERY DISEASE. JAMA. 1957;165(14):1772–1775. doi:10.1001/jama.1957.02980320002002
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