Iglesias-Garriz Ignacio, Rodríguez Miguel Angel, García-Porrero Esteban, Ereño Fernando, Garrote Carmen, Suarez Gonzalo
Division of Cardiology, Hospital de León, León, Spain.
J Am Soc Echocardiogr. 2005 Nov;18(11):1181-6. doi: 10.1016/j.echo.2005.07.020.
We sought to assess the usefulness of stress echocardiography in a chest pain department.
Consecutive patients (n = 487) with nontraumatic chest pain, with no signs of myocardial ischemia on arrival to the emergency department, 6 and 12 hours later, were recruited.
The sensitivity and specificity of stress echocardiography in the biased sample were 74% (95% confidence interval [CI] 63-85%) and 65% (95% CI 44-86%). After application of the method of Begg and Greenes to debias the sample, the calculated sensitivity was 24% (95% CI 19-29%) and specificity was 94% (95% CI 91-97%). After application of Diamond's method, sensitivity was 32% (95% CI 21-44%) and specificity (normalcy rate) was 99% (95% CI 88-100%).
Stress echocardiography is an insensitive test when used to detect significant coronary artery stenosis in patients presenting with nontraumatic chest pain with no objective signs of myocardial ischemia.
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