The exercise test in perspective

In an editorial in the November issue of Circulation Drs. Redwood, Borer and Epstein expressed their concern about performing exercise electrocardiographic testing on asymptomatic persons because some of the abnormal ECG responses occur in individuals who do not have significant coronary arterial obstruction at angiography. Conversely they find such testing to be of limited value in symptomatic individuals because the diagnosis of coronary heart disease is virtually established by the presence of these symptoms. We feel that in each of these concerns there is a mixture of truth and error which calls for further explanation.