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HospitalPharma.com today | 07 February 2012

New findings highlight the benefit of exercise electrocardiograms (ECGs) just as they are being scrapped

In the UK, the exercise electrocardiogram (ECG) is the most common initial test for the evaluation of stable chest pain and has been used widely for almost half a century. However, recent NICE guidelines recommend that it should not be used to diagnose or exclude stable angina in patient assessments. New research published in the BMJ Open finds that the test has other uses that transcend its technical contribution to diagnosis.The study, led by Professor Gene Feder from the University of Bristol, evaluated the role of exercise ECGs in 89 consultations between clinicians and patients across three chest pain clinics.

The researchers report that the functions of the exercise ECG go beyond its diagnostic function and can help clarify symptoms and other aspects of the clinical history by engaging the patient in the diagnostic process while providing a context for guidance on reversible cardiovascular risk factors. For example, the act of walking on the treadmill created an additional opportunity for dialogue between clinician and patient and engagement of the patient in the diagnostic process through precipitation and further elaboration of symptoms.In addition, the exercise ECG facilitated reassurance in relation to exercise capacity and tolerance, providing a platform for behavioural and lifestyle advice particularly when exercise was promoted by the clinician.
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