Look before you do a treadmill test
senior Indian physician has called for the elimination of stress electrocardiogram treadmill tests from routine health check-up packages, saying they may expose healthy people to unnecessary anxiety, costs and more tests, including invasive coronary angiography.
Prem Pais, professor of internal medicine at the St John’s Research Institute, Bangalore, said treadmill tests, when routinely done during health check-ups, can result in unacceptably high rates of “false positives” — or false signals of coronary artery disease (CAD) in people who actually do not have the disease.
People with false positive results may be advised more expensive tests, such as computerised tomography coronary angiography that exposes them to unnecessary X-rays or percutaneous coronary angiography that exposes them to invasive procedures, Pais said in a report published in the Indian Heart Journal.
Some patients with false positive results may even be prescribed treatment for CAD which, he said, would result in unnecessary expenses and possible side effects of the medications.
“It is not advisable to include TMT (treadmill tests) in routine health check-ups. It is important for cardiologists, physicians and members of the public to take note of potential harms from false positive results,” Pais told The Telegraph.
India has a giant market for preventive health check-up packages, driven by pulls from the private health-care sector and demand from health-conscious individuals. Hospitals often include the treadmill test as part of diagnostic tests to assess the risk for CAD.
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