In contrast to these findings, in a study similar to ours, dyspnea was reported to be more frequent in those individuals with a positive thallium stress test who did not have chest pains. However, in that study, dyspnea was reported in the context of it being a test-limiting symptom and, therefore, the absence of chest pains might have produced a bias for other test endpoints, such as dyspnea. In our study, subjects were able to report and quantify any symptoms irrespective of the examiner’s reason for stopping the test, thereby providing a more reliable assessment of symptoms. canadian family pharmacy online
The lack of specificity of dyspnea as a symptom is well recognized. Dyspnea has been found to relate poorly to objective markers of cardiopulmonary disability. Nevertheless, cardiac dysfunction, particularly as evidenced by left ventricular diastolic indices, precedes other indications of myocardial ischemia. Our study suggests that, in general, within the time required for such changes to become evident as dyspnea, perhaps by producing stiffening of the lung, other determinants for stopping the test have already become manifest. Although dyspnea may lack specificity on stress testing, or even as an “anginal equivalent,” its importance as a presenting symptom for other myocardial ischemic syndromes, such as in pulmonary edema or myocardial infarction, is clear.
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