Limitations of current diagnostic tests
Journal of Myocardial Ischemia
Many current tests used in the diagnosis of myocardial ischemia and coronary artery disease (CAD) have important limitations, especially in women. Shifts in the ST-segment on both the resting and exercise ECG, for example, have reduced specificity for detecting cardiac ischemia in women. Noninvasive tests used to detect myocardial perfusion defects or left-ventricular (LV) wall motion abnormalities provide information that is more important for stratifying risk than for accurately quantifying ischemia. Angiography is a definitive test for diagnosing CAD but has important limitations when used to evaluate ischemic heart disease in women. Other diagnostic strategies, such as measurements of absolute lumen dimensions after an endothelium-independent vasodilator and nonangiographic assessments of lumen dimensions, intimal-medial thickness, and endothelial vasodilation, are needed to provide a more complete picture of the atherosclerotic process.
Pepine, C., Lewis, J., Limacher, M., Conti, C., Mehta, J., & Handberg, E. (1995). Limitations of current diagnostic tests. Journal of Myocardial Ischemia, 7 (6). Retrieved from https://hsrc.himmelfarb.gwu.edu/smhs_medicine_facpubs/4613