Abstract

Since 1979 we have carried out symptom limited exercise stress tests for the diagnosis of chest pain in 104 patients, 61 male, 43 female, over 65 years of age; mean age 68+-3 years. An upright bicycle ergometer was used for 64 tests, a treadmill for 38 tests and a supervised walk for 2 patients unable to undergo formal exercise testing. A positive result of >/= 1 mm of ST depression was recorded in 45 of patients; males 57, females 28. Bicycle and treadmill tests were equally likely to produce a positive result; bicycle 43, treadmill 50 (NS). The limiting symptom was chest pain in 43, dyspnoea in 26 and fatigue in 30 of patients. No serious arrhythmias or collapses occurred. During a mean follow up to 24+-18 months 13 patients died. A positive exercise test was associated with a significantly increased risk of cardiac death; 8 of 47 patients with positive tests died compared with 1 of 57 patients with negative or equivocal tests. The remaining 4 deaths were due to malignancy. Exercise testing can thus be safely performed in elderly subjects with the expectation of a high diagnostic yield. A positive result confers a poor prognosis. Verf.-Referat