Sunday Gazette-Mail from Charleston, West Virginia on May 12, 1974 · Page 155
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May 12, 1974

Sunday Gazette-Mail from Charleston, West Virginia · Page 155

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Charleston, West Virginia
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Sunday, May 12, 1974
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Page 155
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Page 155 article text (OCR)

The Heart RtDessTes! UntCnhl SaveYourlife by Arlene Howard Eisenberg T he 38-year-old Wall Street executive in the testing booth looked embarrassed as, electrode leads trailing from his chest, he stepped up onto the exercise treadmill and began to walk up the slight incline. "I'm only doing this to get my wife off my back," he told the exercise physiologist beside him. "Those pains I've been having--they're probably just bursitis." Indeed, a series of resting electrocardiograms (ECG's) over the past four years had revealed no signs of heart disease or damage. But after only 10 minutes on the treadmill, alerted by significant abnormalities on his ECG monitor, cardiologist Abner Delman, medical director of Cardio-Metrics, Inc., of New York City, stopped the test. He recommended follow-up angiocardi- ography--X-rays employing a special contrast dye injected into the coronary blood vessels to precisely outline and pinpoint damage. Film later revealed what Dr. Delman had suspected-- atherosclerosis so advanced that the patient required immediate hospital- ·ization for triple bypass heart surgery. The exercise stress test warning had saved his life. Undetected by routine ECG The 109 passengers and nine crewmen of a British European Airways jet were not so fortunate · at London's Heathrow Airport in June, 1972, when their plane crashed on takeoff, killing all aboard. A Court of Inquiry, armed with an autopsy report on the pilot, established the accident's cause--a coronary shortly after takeoff by the plane's 51- year-old captain. His condition, said the report, "must have been developing for 30 years or more," yet the inexorable narrowing of his coronary arteries had gone undetected in routine annual ECG's in 1970 and 1971. The inquiry report went on to urge coronary stress- testing for all airline pilots. Each year, like the BEA pilot, more than one million Americans are felled by heart attacks--many within weeks, days, or even hours after standard resting ECG's. Only about half survive. "The American Heart Association recommends that all adults over 35 have stress tests for proper evaluation of their hearts," says internist Irving M. Levitas, director of the Cardiac Stress Laboratory at Hackensack'fN.J.) Hospital. "It's unfortunate that physicians, even at well- known diagnostic clinics, continue to test hearts with the patient flat on his back. For the most part, resting ECG's only tell you where you've been, not where you're going. You can have a normal tracing and still be headed for big trouble, because, as a matter of fact, about 60 percent of people with severe coronary disease have normal resting ECG's. You have to test the heart the way you do a car--take it out on the highway and let it ping." How do you safely test your heart in action? For many years, the only answer was the Masters Two-Step Test, which The exercise ECG: A doctor at Cardio-Metrics laboratories continuously monitors the heart in action as the patient in booth works out on a stationary bicycle. involved the patient's stepping on and off a two-level, platform' for a three- minute period. But the Masters, though just right for some patients, stressed some too little and others too much. And it was the latter that worried many physicians, who resisted using the test, despite its virtues, because of the possibility--however remote--that a patient might somehow drop dead in the office. He knows when to stop With the new exercise ECG's, continuous monitoring of heart action provides a broad safety factor--fewer than one fatality in 10,000 is the theoretical risk. Gradually increased workloads on a stationary bicycle or treadmill tailor the test precisely to each individual. A cardiologist monitors your heart's reactions, stopping you when you reach 85 percent of your cardiovascular capacity, or when an abnormal reading of ECG or blood pressure warns of danger ahead. "What we get," says the exercise lab's director William S. Gaultiere, Ph.D., a physiologist, "is an indirect image of the extent that atherosclerosis has narrowed the individual's coronary vessels." Says Dr. Samuel M. Fox III, past president of the American College of Cardiology: "The evidence is very strong that exercise stress testing is a powerful

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