Discussion Paper Title

Assessment of chest pain in a low risk patient: is the exercise tolerance test obsolete?

Background

This is one of a series of occasional articles that highlight areas of practice where management lacks convincing supporting evidence. The series adviser is David Tovey, editor in chief, the Cochrane Library. To suggest a topic for this series, please email us at uncertainties@bmj.com

Outline

A 55 year old man presents with chest pain that he has had for a few months. He is a keen cyclist and a non-smoker with normal blood pressure. He has a serum total cholesterol concentration of 6.1 mmol/L (with an high density lipoprotein cholesterol concentration of 1.5 mmol/L). The chest pain is anterior, poorly localised, mild, and intermittent, though sometimes associated with exercise. It generally resolves after a few minutes whether or not the patient continues to exercise. Examination and his resting 12 lead electrocardiograph are normal.

Document

Assessment of Chest Pain in a Low Risk Patient, Is the Exercise Tolerance Test Obsolete (Barraclough et al., 2015)

Reference

Barraclough, K., Gale, C.P. & Hall, R. (2015) Assessment of Chest Pain in a Low Risk Patient: Is The Exercise Tolerance Test Obsolete? British Medical Journal. BMJ 2015;350:h1905. doi: 10.1136/bmj.h1905 (Published 6 May 2015)