False-Positive Stress Echocardiograms: A Continuing Challenge Article

PMID: 27660577 Web of Science: 000389241000018

Cited authors

  • Qamruddin, Salima


  • Background: Stress echocardiography is an integral test in the cardiac diagnostic laboratory and has high sensitivity and specificity. Despite the excellent specificity of stress echocardiography, we continue to see a subset of patients with false-positive tests (defined as < 50% diameter stenosis on subsequent coronary angiography). These false-positive findings present a management challenge because it remains unclear if and how to treat these patients.; Methods: This article reviews relevant clinical studies and their outcomes.; Results: Studies suggest that a group of patients develops a hypertensive response to exercise and therefore may have false-positive stress echocardiography. Hence, superior blood pressure control prior to stress echocardiography may prevent some false-positive tests. In addition, a subset of patients has microvascular abnormalities, vasomotor changes, endothelial dysfunction, and/or small vessel coronary disease that can lead to false-positive stress echocardiography.; Conclusion: The evidence is insufficient to state that a false-positive stress echocardiography in the absence of obstructive coronary artery disease portends a poor outcome, but considerable evidence shows that some of these patients have microvascular abnormalities and endothelial dysfunction and consequently may benefit from aggressive medical management and further testing.

Publication date

  • 2016

Published in

International Standard Serial Number (ISSN)

  • 1524-5012

Start page

  • 277

End page

  • 279


  • 16


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