Recently, the limitations of the exercise (stress) ECG test
in the diagnosis of coronary artery disease (CAD) have
been overemphasized, particularly in the asymptomatic
population.1-3 Nevertheless, many physicians who have
extensive and clinical investigative experience with the
exercise ECG test are fully convinced that the test provides
great value in the diagnosis of CAD and in the assessment
of functional capacity.4.5
Some physicians who are skeptical about the value of the
exercise ECG test for the screening of presumably healthy
individuals are constantly disturbed by the high incidence
(35% to 36%) of "false"-positive tests—ST segment
responses.6.7 They criticize that a false-positive exercise
ECG test frequently leads to psychological trauma (production of "cardiac neurosis") for the individual who has no
CAD. It should be emphasized, however, that psychological
trauma is usually physician-induced and by no means
test-induced. The psychological reaction will largely
depend on the physician's approach to a given individual