| The exercise treadmill test is a non invasive test used for the diagnosis of coronary artery disease, exercise- induced arrhythmias and to assess cardiovascular fitness in athletes. The patient performs graded exercise on a treadmill while his ECG and blood pressure are continuously being monitored. |
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| The exercise treadmill test has a diagnostic accuracy of about 65-70% for the diagnosis of coronary artery disease. As with all diagnostic tests, there may be false positives and false negatives. |
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| A false positive test is when a test is positive for a disease when in reality the disease is not present. A false negative is when the test shows a negative result when the disease is in fact present. |
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| False positive treadmill tests are more common in women. Mitral valve prolapse, anemia and drugs like digoxin can also cause false positive results. |
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| False negative treadmill tests occur when there are blockages in all three blood vessels supplying the heart, as ECG changes during exercise do not appear when the blood supply is equally reduced in all three vessels during the exercise test. |
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| When used in health screening for coronary artery disease, positive tests need to be followed up by more accurate confirmatory tests such as coronary angiography. When the clinical suspicion of coronary artery disease is high, even in the presence of a negative test, a more definitive test (such as coronary angiography) should be done to prove the presence or absence of disease. |
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