Published 13 November 2008, doi:10.1136/bmj.a2340
Cite this as: BMJ 2008;337:a2340

Editorials

Electrocardiography in suspected angina

Is poor at predicting future events, but still an essential part of assessment

The first 150 words of the full text of this article appear below.

In the linked cohort study (doi:10.1136/bmj.a2240), Sekhri and colleagues assess whether resting and exercise electrocardiograms (ECGs) provide superior prognostic value to that obtained from the clinical history in ambulatory patients with suspected angina.¹ The study indicates that the clinical assessment accounts for most of the prognostic information provided by resting and exercise ECGs.

Other studies and algorithms have used the patient’s pretest probability to help with diagnosis,² but long term prediction of risk and the incremental usefulness of the ECG have not been evaluated in this way.

The study is a reminder of the importance of taking a detailed history and making a thorough physical examination, and that additional information from the ECG is helpful in some patients but does not predict risk in everyone. The results do not mean that ECGs and stress tests are not useful, because an abnormal ECG and abnormal stress test independently predicted . . . [Full text of this article]

¹ Cardiac Prevention Centre, Division of Cardiology, St Michael’s Hospital, Toronto, ON, Canada M5B 1W8

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Cost effective investigation of suspected angina

S Richard Underwood
BMJ 2008 337: a3097. [Extract] [Full Text]

Incremental prognostic value of the exercise electrocardiogram in the initial assessment of patients with suspected angina: cohort study

Neha Sekhri, Gene S Feder, Cornelia Junghans, Sandra Eldridge, Athavan Umaipalan, Rashmi Madhu, Harry Hemingway, and Adam D Timmis
BMJ 2008 337: a2240. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Underwood, S R. (2008). Cost effective investigation of suspected angina. BMJ 337: a3097-a3097 [Full text]  

Rapid Responses:

Read all Rapid Responses

Lead Placement in ECGs

Richard A Hutchinson
bmj.com, 28 Nov 2008 [Full text]

Cost effective investigation of suspected angina

S Richard Underwood, et al.
bmj.com, 30 Nov 2008 [Full text]

Online poll

Find out more >>