In order to accurately interpret an exercise ECG, it is essential to know why it was completed.

An exercise ECG is usually obtained for one of the following reasons:

• To screen for the presence of undiagnosed coronary heart disease, especially in individuals with one or more unfavorable coronary risk factors (cigarette smoking, hypertension, elevated cholesterol, family history of coronary heart disease at a young age, or diabetes), or in an individual with other known atherosclerotic impairments
• To evaluate an individual with chest pain
• To clarify abnormalities found on a resting ECG
• To assess the severity of known coronary heart disease

The proper interpretation of an exercise test is dependent upon the underlying likelihood of coronary heart disease, a detailed knowledge of any prior medical history, and additional diagnostic studies that have been performed.

In the final analysis, the likelihood that a positive (abnormal) exercise test represents ischemia depends on coronary risk factors, the presence of pain (angina), and the results of any additional studies completed after a positive exercise test.

An abnormal exercise ECG is classified as being mildly, moderately, or strongly positive. Depending on the other coronary risk factors, the ratings for an abnormal exercise ECG would be:

Mild                             
Table B   

Moderate 
Table C                      

Strong
Table D

Following an abnormal exercise test it is common practice to do additional studies to confirm the finding. When these tests, such as thallium scan, exercise echocardiogram, or cardiac catheterization are completed, the rating may be modified depending upon the results of these tests. Normal additional tests often allow a reduction in the above ratings.

To get an idea of how a client with an abnormal stress ECG history would be viewed in the underwriting process, please feel free to contact American Brokerage Services, Inc. at 888-227-3131 for an informal quote or to request additional information.

For Internal Use Only. Not For Use With The Public.

This material is intended for insurance informational purposes only and is not personal medical advice for clients.