Exercise testing: screening and reproducibility in asymptomatic subjects.

The recent application of exercise electrocardiography in asymptomatic populations requires the physician to be aware of the differences in sensitivity, specificity, and predictive value when compared with its application in the symptomatic population. Strict application of standard testing methodology is necessary to assure valid data collection and to permit the most meaningful interpretation. The prevalence of the false-positive electrocardiogram is distressingly frequent and often eventuates in further diagnostic testing. The asymptomatic positive ECG response does increase the risk of development of overt manifestations of ischemic heart disease. Routine testing in the asymptomatic population should be limited to high-risk population subsets.