Safety and utility of exercise testing in emergency room chest pain centers: An advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical Cardiology, American Heart Association

When reviewed together, the studies summarized here confirm the safety of symptom-limited treadmill exercise ECG testing after 8 to 12 hours of evaluation in patients who have been identified as being at low to intermediate risk by a clinical algorithm that uses serum markers of myocardial necrosis and resting ECGs. This is consistent with similar safety data reported in patient groups with a higher disease prevalence, such as patients presenting with unstable angina. Utility, expressed as the incremental clinical value of exercise ECG testing when added to a chest pain center clinical algorithm, serial serum markers of myocardial necrosis, and serial ECG testing, has been demonstrated in at least 2 well-designed studies.