By Frederick R. Jelovsek, M.D.,
A stress EKG or exercise EKG is known to be less accurate in women than men.
A somewhat different study, an exercise echocardiogram, has been suggested to
be a more accurate test for coronary artery disease in women. A recent
study by Heupler at Cleveland Clinic, Prognostic implications of exercise
echocardiography in women with known or suspected coronary artery disease.
J Am Coll Cardiol. 1977 Aug; 30:414-20, indicates that echocardiographic evidence
of ischemia (lack of oxygen to the heart) is a strong predictor of having an adverse
cardiac event. It was more accurate than the exercise EKG.
In the exercise echocardiogram xray imaging is involved rather than just
hooking up the electrodes of a standard EKG. This makes the test somewhat
more expensive. It did, however, predict almost twice as many cardiac events such as
myocardial infarction or even death.
If your doctor suspects you may have coronary artery disease, it is likely
that one of the two studies will be ordered. Discuss this with the physician
to see which is the best for you.
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