The EST identified 30% of patients with a blood supply/demand mismatch

Researchers from King’s College London (KCL) have revealed that the revival of a heart stress test was successful when put to the test against contemporary standards in heart care.

Published in the Journal of American College of Cardiology, the electrocardiogram exercise stress test (EST) was accurate in identifying abnormalities in the heart’s blood supply.

Previously, the EST was a popular way of assessing patients with angina – attacks of chest pain caused by reduced blood flow to the heart.

The test required a patient to exercise on a treadmill or stationary bike while a cardiologist distinguished whether the blood supply to the heart muscle matched the demand during physical stress.

However, due to its perceived inaccuracies, the EST test fell out of favour.

KCL researchers, however, questioned this after discovering that an abnormal EST was successful in picking up abnormalities in the vessels supplying the heart muscle with blood.

Researchers tested the accuracy of ESTs after comprehensively assessing 102 patients living with angina without narrowing in the large blood vessels’ functions of both the large and small blood vessels before carrying out an EST.

They found that around 30% of patients had evidence of a blood supply/demand mismatch on the EST, all of whom had had inaccurate testing prior. Furthermore, all of these patients also showed abnormalities in their small blood vessels.

The results from the study showed that the EST is accurate in identifying patients who have abnormalities in their large or small blood vessels, which supply the heart muscle.

Dr Aish Sinha, a KCL PhD student who participated in the study, said: “These findings have significant implications for the way in which we view the diagnostic accuracy of all non-invasive tests.

“This study has far-reaching implications as it may make a currently difficult-to-diagnose condition far easier to identify and, subsequently, treat.”

He added that “these hypotheses warrant further randomised trials to answer them”.