Electrocardiography in suspected angina

doi:10.1136/bmj.a2340

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Beth Abramson, director

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

abramsonb{at}smh.toronto.on.ca

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

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 …