245 Exercise Treadmill Test In General Practice

SUMANEN Markku, Kangasala Health Centre, Finland, E-mail: markku.sumanen@kolumbus.fi
Exercise treadmill test is an essential examination in diagnosing coronary artery disease. Traditionally it has been done only at specialist level.
Aims: To determine the implementation, findings and further measures of the exercise treadmill tests done in general practice.
Method: The study consists of 246 patients examined by GPs with the test at Kangasala health centre in the year 1998. The medications of the patients were recorded; beta-blockers, calcium antagonist, long-acting nitrates and digoxin were of most importance. The reason of the test was determined. Special attention was paid to whether or not the patient had ischaemic heart disease. The maximal ST-depression was recorded. Possible chest pain was noticed. The findings were classified as positive, negative or unsure. Finally, the followed measures of the patients were recorded.
Results: The mean age of the patients was 58 years. Only 4% of the tests failed, the main reason was the use of beta-blockers. In 88% of the patients the indication for the test was associated with coronary heart disease. Anamnestically 17% of the patients already had ischaemic heart disease. Concerning heart disease 24% of the tests were considered positive. Of the patients 21% were referred to further measures, the medication was changed in 21%, 22% remained at GPs follow-up, other specific therapy was given to 5%, in 31% the treatment did not alter.
Exercise treadmill test can be easily and safely done by GPs. It is useful in general practice; it helps in diagnosing coronary artery disease and finding the right patients to further investigations.