Regulate Exercise ECG Program- Role of Exercise ECG in the Assessment of Coronary Artery Disease in a Tertiary Care Hospital in Sri Lanka

Rahuman MBF1*, Rajakanthan K1, Senevirathne N1, Rathnayake C1, Westlly N1, Theivendram D1, Nawaratna A2 and De Silva P3

1Colombo South Teaching Hospital, Colombo, Sri Lanka
2National Hospital, Colombo, Sri Lanka
3Clinical Epidemiology and Public Health, Ministry of Health, Colombo, Sri Lanka

^*Correspondance to: Rahuman MBF 

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Abstract:

Background: Cardiovascular disease is a major cause of death worldwide. The exercise ECG (Ex ECG, ETT) is non-invasive, inexpensive method to yield substantial data for risk stratification of CAD. This study aims to show that this modality of testing carries significance in the evaluation of patients suspected or already diagnosed with CAD. Methods: This analytical cross-sectional study was conducted among 3,000 patients who were referred for ETT at the cardiology unit of Colombo South Teaching Hospital, Sri Lanka between November 2018 and February 2020. ETT was done using classical Bruce protocol and majority of ETT positive patients were referred for Coronary Angiogram (CA). Follow up was conducted up to 2 years post enrollment. Results: Among the 3,000 patients, 797 (26.6%) positive, 1896 (63.2%) negative and 307 (10.2%) inconclusive ETT outcomes were found. 698 (23.3%) ETT positive patients were referred for a coronary angiogram. The frequent indication of ETT was chest pain (67.1%). Hypertension, Dyslipidemia, Diabetes Mellitus, CKD, and Smoking were the risk factors present in the population with 57.3%, 62.3%, 34.2%, 1.7% and 4.9% respectively. Conclusion: Among the positive ETT outcome, majority were males 421 (52.8%) and older (≥ 41 years) and Non-ST-Elevation Myocardial Infarction (NSTEMI) was the common clinical pattern. Dyslipidemia was the commonest risk factor in the study population. Past history of CAD was not significant in positive ETT population. Majority of patients on beta blockers achieved the target heart rate. Exercise induced ST depression mainly demonstrated in inferolateral leads which was not significant in localizing ischemia. Results of CA in the positive ETT population showed CAD in majority and Triple Vessel Disease (TVD) was most common.

Keywords:

Exercise ECG; ST Segment Depression; CAD; Dyslipidemia; Diabetes Mellitus

Cite the Article:

Rahuman MBF, Rajakanthan K, Senevirathne N, Rathnayake C, Westlly N, Theivendram D, et al. Regulate Exercise ECG Program- Role of Exercise ECG in the Assessment of Coronary Artery Disease in a Tertiary Care Hospital in Sri Lanka. Ann Clin Case Rep. 2024; 9: 2660..