Abbott J A, Tedeschi M A, Cheitlin M D
West J Med. 1977 Mar;126(3):173-8.
Treadmill stress testing is used in assessing the condition of patients with known or suspected heart disease. We did a prospective study to clarify physician ordering and integration of the test. Ordering criteria were always complied with, although most tests were ordered for evaluation of atypical chest pain and only a few for high risk patients with known cardiac dysfunction, indicating a misplaced emphasis on the diagnostic capabilities of the test. Tests in patients with atypical chest pain and stress-induced ischemic changes were always integrated, but in 30 percent of patients with atypical pain and no stress-induced electrocardiographic changes, the tests were not used in patient management. This was often due to the misconception that negative findings on a stress test excluded coronary disease. Physicians should be alerted to this misplaced emphasis and misconception.
跑步机压力测试用于评估已知或疑似患有心脏病患者的病情。我们进行了一项前瞻性研究，以阐明医生对该测试的开具医嘱情况及测试的整合情况。医嘱标准始终得到遵守，尽管大多数测试是为评估非典型胸痛而开具的，只有少数是为已知心脏功能障碍的高危患者开具的，这表明对该测试诊断能力的重视错位。非典型胸痛且有压力诱发缺血性改变患者的测试始终被整合，但在30%非典型胸痛且无压力诱发心电图改变的患者中，该测试未用于患者管理。这通常是由于误解了压力测试结果为阴性就排除冠心病。应提醒医生注意这种重视错位和误解。
