Exercise electrocardiography in the management of obstructive coronary artery disease and other cardiac disorders

Exercise electrocardiography (exercise ECG) is the least expensive and most readily available functional test for obstructive coronary artery disease (CAD). Its major weakness is limited accuracy, with a false negative rate of around 50% (sensitivity 50%), and a false positive rate of around 10% (specificity 90%). We discuss the information yielded by exercise ECG and its use in decision-making for patients with suspected or known CAD. The role of exercise ECG in the management of other cardiac disorders is also reviewed. We summarize the practical aspects of performing exercise ECG.