Is it safe to have an exercise ECG test after a heart attack?
There is not enough safety information to justify exercise ECG testing in the first 2 to 3 days after a heart attack. It is safe to do a treadmill test more than 5 days after an uncomplicated heart attack, when stress testing can help determine a safe level of activity. A negative (normal) test means you have a low risk of having another heart attack. If you are unable to perform an exercise ECG, you are at a higher risk of having another heart attack or dying from heart disease.18, 19 You should also have an exercise ECG before starting cardiac rehabilitation or any type of exercise program.
Does an exercise ECG have any limitations?
A normal exercise ECG is a reliable test for ruling out heart problems in women. In terms of the print out showing the heart's electrical activity, a positive exercise ECG is less reliable for women than for men. Women are prone to false positive results—the test detects a problem, but in reality there is none. Chest pain during exercise testing is also less likely to be a sign of heart disease in women than in men. Because of these limitations, you should not be referred for invasive testing such as cardiac catheterization based on a positive exercise ECG alone. The results should be confirmed through further noninvasive testing first, such as echocardiography or a nuclear stress test.
However, the exercise ECG measures a lot more than just the print out of the heart's electrical activity. It also measures your exercise capacity, and how your blood pressure and heart rate are affected by exercise. When these factors are looked at, the exercise ECG is an excellent test for predicting your risk of having a heart attack or dying from heart disease.
References
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2. Gibbons RJ, Balady GJ, Timothy Bricker J, et al. ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). J Am Coll Cardiol. 2002;40:1531-1540.
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