Treadmill test verus Holter monitoring in detection of silent myocardial ischaemia in patients with chronic stable angina

ABSTRACT

The study was conducted on 34 patients with chronic stable angina [31 males and 3 females] with the age ranging from 29 to 67 years with a mean 49.7 years. Treadmill exercise ECG test showed that 27 patients [79 percent] had a positive result and 7 patients [21 percent] had a negative result. Ten patients [29 percent] had silent ST-segment depression. During Holter monitoring, a total of 48960 minutes were analyzed 1841 minutes of ischaemic activity were recorded, 1564 minutes [85 percent] were silent. The total number of ischaemic episodes recorded, 147 of which 112 [76 percent] were silent. The total number of patients who developed silent ischaemic on Holter monitoring was 18 patients [54 percent]. Seventeen patients [94 percent] out of those 18 patients had a positive stress test result and one patient [6 percent] had a negative result [P<0.01]. Silent ischaemic episodes are more frequent among patients who developed earlier ST-segment depression on exercise and at lower heart rate and if ischaemica persisted after exercise. The two methods of investigation seem to complement each other in clinical practice to identify subgroup of patients with stable angina at a higher risk of cardiac events