"Provocative Exercise Testing-A New Role for Cardiac Rehabilitation", North Carolina Medical Journal, June 1985. Charles L. Baird, Jr., M. D.

EXERCISE testing is widely accepted for diagnostic and prognostic purposes in the management of ischemic heart disease. However, its role in the serial evaluation of therapeutic intervention has been limited due to cost, inconvenience and the failure to appreciate the necessity for objective pharmacologic control of myocardial ischemia. The cardiac rehabilitation program at the Virginia Heart Institute was modiOed to include nursing-supervised provocative exercise testing as a method of selecting therapy. Those patients whose exercise-induced myocardial ischemia could not be reversed pharmacologically or whose exercise performances were complicated by fatigue, hypotension or drug intolerance were considered for surgical intervention. The experience of the Virginia Heart Institute from 1976 to 1982 and the provision of provocative exercise testing during a six-week cardiac rehabilitation program are presented.