Diagnostic procedures for myocardial ischaemia.

It is important to detect the problem of ischaemic heart disease at a manageable stage at which treatments could have beneficial effects. A positive exercise test in patients with known ischaemic heart disease is a risk factor for cardiac mortality and there is a need to devise treatment strategies that take into account different approaches to higher- and lower-risk patients with ischaemic heart disease. In patients with stable angina pectoris, ST-segment depression on continuous ambulatory ECG monitoring is a reliable method of assessing ischaemic events in patients going about their normal daily activities. However, at the present time both of these assessment methods should only be considered for screening individuals already suspected of being at high risk of cardiovascular morbidity and mortality.