[Value of long-term ECG monitoring in the diagnosis of coronary disease--comparison of 8-hour ECG monitoring and double Master exercise test with a clinical coronary index].

The use of the long term Ecg (dynamic Ecg) in the diagnosis of coronary artery disease (CAD) has been investigated in 83 patients and its sensitivity compared with the double Master two step test. The average ECG registration time was 8 hours. The presence of CAD was assumed when the clinical index according to Cohn et al. revealed a pathological value. If a horizontal or downsloping ST-segment depression of greater than or equal to 0,5 mm was chosen for the diagnosis of CAD a sensitivity of 82% resp. 64% was found for the dynamic Ecg and the double Master two step test. The specificity of the dynamic Ecg however was with 77% slightly inferior compared with the Master-test. The superiority in sensitivity of the dynamic Ecg was also present when the diagnosis of CAD was based on a ST-segment depression of greater than or equal to 1,0 mm. We believe that the dynamic Ecg can provide besides arrhythmia detection valuable information in the diagnosis of CAD and careful interpretation of the ST-segment should therefore be undertaken. The number of false positive results in the diagnosis of CAD was not influenced by the women included in the study.