Læknablaðið - 15.05.1987, Blaðsíða 18

158
LÆKNABLAÐIÐ
forspárgildi fyrir kransæðasjúkdóm er
viðsnúningur á U-takka (13).
Niðurstöður okkar benda til þess að töluverð
fylgni sé á milli sjúkrasögu og niðurstöðu
áreynsluprófsins. í áhættuhópi var
áreynsluprófið gagnlegt til að finna merki um
kransæðasjúkdóm. Eftirathugun leiddi í ljós, að
okkur hafði ekki við áreynsluprófin yfirsést neinn
einstaklingur með alvarlegan kransæðasjúkdóm
og virðist því áreynsluprófið einnig gagnlegt til að
útiloka útbreiddan kransæðasjúkdóm. Það er þó
talið til lítils að leita að kransæðasjúkdómi með
áreynsluprófi hjá einkennalausum einstaklingum,
til dæmis í hópskoðunum vegna hlutfallslegrar
aukningar á fjölda falsk-jákvæðra prófa (14-17).
Lokaorð: Megin ályktanir okkar eftir reynslu af
þessum áreynsluprófum á Fjórðungssjúkrahúsinu
á Akureyri eru sem hér segir:
Áreynsluprófið er gagnlegt til að finna
kransæðasjúkdóm í áhættuhópi.
Áreynsluprófið virðist einnig gagnlegt til að
útiloka kransæðasjúkdóma á alvarlegu stigi.
Áreynsluprófið er áhættulítið, en fylgikvillar geta
þó verið alvarlegir og er því skylt að viðhafa
fyllsta öryggi.
Þakkir: Höfundar færa Valgerði Jónsdóttur
sérstakar þakkir, en hún aðstoðaði við öll
áreynsluprófin.
SUMMARY
Exercise test on bycycle ergometer. Review of 146 tests
at Akureyri Hospital (FSA).
Between October lst 1983 and March lst 1985, 146
exercise tests were performed on 140 individuals (6 were
tested twice). 103 males and 37 females. Their age was
from 9 to 75 years, with an average of 50.5 years. Forty
two had signs indicating coronary artery disease, 90
were negative, and 8 had an uncertain outcome. The
group was divided into 6 subgroups on account of their
clinical symptoms and indications for the test. Group 1
comprised patients with clear angina pectoris, a total of
30, group 2 suspision of angina pectoris, 29, group 3
chest pain of other origin, 27, group 4 indications other
than coronary artery disease, 14, group 5 individuals
without symptoms, 23, group 6 previous known
coronary artery disease (previous infarction, coronary
operation or angiography). 83% of group 1 were
positive, 28% of group 2, 52% of group 6 but none of
groups 3, 4 and 5. Of 42 positive individuals, 23 were
referred for coronary angiography and 19 received drug
treatment only for their symptoms, without further
investigation. Of 23 who had coronary angiography, 21
were found to have coronary artery disease, one had a
valve disease and one hand normal coronary arteries but
had typical history of angina pectoris. Fourteen
underwent coronary bypass, 2 underwent PTCA and 4
received drug treatment only. One died suddenly while
waiting operation.
A follow up was performed on the whole group 12 to 30
months after the exercise test. Of 98 who had negative or
an uncertain outcome, none had had any major
coronary episode or any symptoms of coronary disease.
The exercise test as performed at Akureyri hospital was
obviously useful in discovering coronary artery disease
in a risk group. The exercise test was also useful in ruling
out serious coronary artery disease as a cause of chest
pain. The exercise test was a safe procedure, risks and
complications were few, but potentially dangerous,
emphasizing the importance of utmost precaution
during the test.
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