If you’ve always imagined that all a woman needs to do, to find out if she has clogged coronary arteries (heart disease), is to take a treadmill stress test so that doctors can see if there’s restricted blood flow during exercise — think again.
Maybe one day it will be that easy, but currently, it’s nowhere near it. A study in the Dec. 2012 issue of The American Journal of Cardiology reports a promising conclusion to researchers’ investigation of treadmill stress tests identifying heart disease in women.
However, the percentages aren’t exactly super high, as you’re about to find out. The report points out that many physicians don’t put a lot of faith in the accuracy of the exercise treadmill test (ETT) in detecting women’s heart disease.
Nevertheless, the researchers, from UC Davis, discovered that the exercise treadmill test can accurately predict heart disease in women over age 65. Though this sounds great, it’s not too impressive for women under age 65.
The paper notes that the predictive efficacy of the treadmill stress test was enhanced by two particular EKG indications.
There are more accurate ways to identify the presence of coronary artery disease, says Dr. Ezra Amsterdam, the study’s senior author. Dr. Amsterdam adds that these other ways are more expensive.
“Our study found that the [treadmill] test is a very valuable tool for identifying coronary artery disease in women older than 65,” explains Dr. Amsterdam, “and that it can be used to help select those who may require higher-tech diagnostics.”
The exercise treadmill exam includes an EKG reading. If the exam detects signs of heart disease, then more invasive and definitive procedures are warranted, such as the catheter angiogram. This is actually the gold standard in identifying blockages, but it’s very invasive and carries with it the risk of stroke and heart attack.
My mother (who did not have a treadmill stress test) had a catheter angiogram, and prior to the procedure, she had to sign a waiver that had some pretty frightening information on it.
Dr. Amsterdam’s study involved 111 women who reported chest pain and whose treadmill results were “positive.” These women underwent catheter angiograms.
The Results
Half the women had heart disease (determined by the cath angiogram). When the results were broken down by age, the percentage went up to 68 percent for women over age 65, and down to 36 percent for women 35 to 50. The percentage for the older women may not seem impressive, but to the researchers, it’s a mark of a successful procedure.
What about the EKG?
Two indicators, called the ST-segment depression and the ST-segment recovery, turned out to be important to the ETT’s diagnostic value. For women over 65, longer ST-segment recovery time yielded an 80 percent prediction rate of heart disease.
