Angina: DDx of atypical presentations in the elderly.

Pretest probability of coronary heart disease should be considered in interpreting exercise test results. In general, 90% of patients with typical angina pectoris, 50% of patients with atypical angina pectoris, and only 10% of patients with nonanginal chest pains have CHD. Marked ST-segment depression in multiple leads is a good indication of extensive coronary artery disease, especially when it occurs early during exercise or at submaximal exercise, and if associated with a blunted or a hypotensive BP response.