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viernes, 9 de enero de 2015

Pruebas de esfuerzo cardíacas

Prior D. Australian Family Physician 2012; 41 (3): 119-122
"Stress testing is most valuable in patients of intermediate pretest probability (10% < pretestprobability <90%), as it is in this group that a change in risk stratification is most likely, ie. to low or high risk. It is not unreasonable in some patients with high pretest probability (eg. typical angina in men aged >50 years or in women aged >60 years) to consider coronary angiography as an initial diagnostic test. As stress ECG should not be ordered when the baseline ECG shows a complete LBBB, paced ventricular rhythm, pre-excitation syndrome (Wolf-Parkinson-White syndrome), or more than 1 mm ST segment depression (eg. associated with left ventricular hypertrophy or digitalis effect). In these cases, ischaemic ECG changes cannot be identified and an imaging stress test should be considered."