A model to predict multivessel coronary artery disease from the exercise thallium-201 stress test
Article Abstract:
Treatment of coronary artery disease (CAD), or disease of the major blood vessels supplying the heart, is aimed at alleviating symptoms and prolonging the life of the patient. Revascularization, the renewal of blood supply to the heart, can be accomplished by bypass surgery, which provides an alternate route of flow to the heart by bypassing the diseased blood vessel, or by balloon angioplasty, the dilation of the narrowed blood vessel with a small inflatable balloon. Patients with multivessel disease, or CAD involving more than one coronary artery, benefit most in terms of survival from revascularization. Hence, it is important to distinguish patients with multivessel disease from those with single-vessel disease. A noninvasive method for identifying patients with multivessel disease would be the most practical approach for screening large numbers of persons for CAD. Exercise thallium-201 imaging is the most reliable noninvasive method for detecting CAD; this involves injecting dye into the bloodstream while the patient exercises and then imaging the heart for abnormalities. It is not clear whether exercise electrocardiography, the recording of the electrical activity of the heart during exercise, and clinical factors, such as age, gender, and type of chest pain, help in detecting multivessel CAD. The effectiveness of combining results from thallium-201 imaging with those of exercise electrocardiography and clinical history in diagnosis of CAD was assessed in two studies, one involving 383 patients and one involving 325 patients. The results showed that depression of the ST segment in the electrocardiogram and patient age added to the ability to detect multivessel disease using thallium-201 imaging. Three factors that predicted multivessel disease, which were age, ST depression, and defects identified by thallium-201 imaging, were used to develop a model. This model was shown to be accurate in predicting the occurrence of multivessel disease. The findings indicate that factors other than imaging results, such as age and ST depression, contribute to the detection of multivessel disease when thallium-201 imaging is also used. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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The baseline electrocardiogram
Article Abstract:
Asymptomatic people undergo screening procedures when disease in an early, more treatable stage is suspected, or when baseline information is desired in the event that disease develops later. Some screening tests, such as the routine chest X-ray, have recently come under attack as unnecessary; others have been limited in frequency or in application. Baseline tests, such as the electrocardiogram (ECG; recording of the electrical activity of the heart), should be evaluated in a similarly critical manner. This editorial presents criteria for obtaining a baseline ECG and suggests ways of evaluating it to guide patient management. The test is most useful for people with heart disease, for the elderly, and for those with risk factors for cardiovascular disease. Such people are advised to bring a copy of their ECG if they must go to the hospital on an emergency basis. Another article in the December 1991 issue of The American Journal of Medicine discusses the use of the ECG in elderly patients. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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