Clinical Characteristics and Temporal Profile of Patients Referred to a Cardiac Centre for Stress Electrocardiography (ECG) in Southern Nigeria

Background: The stress electrocardiographic (ECG), is a dependable method for evaluating cardiovascular health and examining potential heart conditions like myocardial ischemia and arrhythmia. EST is rare in cardiac settings with limited data on diagnosis in the developing worlds. Our main goal was to determine the clinical characteristics of patients referred to our cardiac center.

Methods: A retrospective cross-sectional study of adult patients aged (>18 years old) with low or intermediate pretest symptoms referred for EST to GoodHeart Medical consultant hospital between October 2019 and January 2023. Data included medication, smoking, alcohol, medical history, and symptoms.

Results: In a study with 102 subjects (mean age: 49±16 years), 57.8% were aged 41-60, and 72.5% were males. Routine medical fitness and chest pain were common indications for EST. 80% of subjects with positive arrhythmia and 50% with positive ischemia had chest pain. None of the patient presenting for routine medical fitness had arrhythmia while 14.3% had ischemia. Arrhythmia correlated significantly with chest pain. Among those with positive ischemia, 71.4% were hypertensive and 64.2% were obese; none smoked or consumed alcohol. For positive arrhythmia cases, 70% were hypertensive and 80% were obese; 40%, 20%, and 10% smoked, consumed alcohol, and were diabetic, respectively.

Conclusion: Majority of subjects that underwent the EST has normal result and the few that had positive ischemia 13.7% were referred for angiography and angioplasty while subject with positive arrhythmia 9.8% were recommended for Holter ECG and electrophysiology studies. The occurrence of major cardiovascular events was rare.