La prueba de esfuerzo electrocardiográfica: utilidad en el diagnóstico y pronóstico de la enfermedad coronaria
Resumen
La prueba de esfuerzo electrocardiográfica evalúa los ajustes fisiológicos en respuesta a un aumento en el metabolismo; además, permite establecer el diagnóstico y pronóstico de diferentes enfermedades cardiovasculares. Esta prueba continúa siendo el método diagnóstico de más fácil acceso y menos costoso para la evaluación inicial de pacientes con síntomas estables, que tienen un riesgo bajo o intermedio de enfermedad coronaria, y en aquellas personas con dolor torácico que consultan al servicio de urgencias. Sin embargo, posee limitaciones en la exactitud diagnóstica, con falsos negativos alrededor del 40% (sensibilidad del 60%) y falsos positivos alrededor del 10% (especificidad del 90%). En este artículo se discute información sobre la prueba de esfuerzo electrocardiográfica, su aplicación tanto para el diagnóstico como el pronóstico y su utilidad en la toma de decisiones en los pacientes en quienes se sospecha o tienen una enfermedad coronaria. Igualmente, se presentan aspectos prácticos para la realización del procedimiento, una propuesta de informe con los principales hallazgos y algunos ejemplos clínicos.
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