Evidence on harms was limited , but direct harms seemed minimal ( for resting ECG ) or small ( for exercise ECG ) .
BACKGROUND Coronary heart disease is the leading cause of death in adults .
Screening for abnormalities by using resting or exercise electrocardiography ( ECG ) might help identify persons who would benefit from interventions to reduce cardiovascular risk .
PURPOSE To up date the 2004 U.S. Preventive Services Task Force evidence review on screening for  resting or exercise ECG abnormalities in asymptomatic adults .
Detecting Occult Coronary Disease in a High-Risk Asymptomatic Population
Background —Exercise stress testing alone or with perfusion imaging is the st and ard screening method to determine the presence of obstructive coronary artery disease ( CAD ) in people with chest pain . In asymptomatic individuals with a family history of premature CAD , it is unclear whether abnormalities on these functional exercise tests represent significant coronary disease . Methods and Results —An abnormal exercise test , thallium scan , or both occurred in 153 ( 21 % ) of 734 asymptomatic siblings of persons with documented CAD , of whom 105 underwent coronary angiography with quantitative analysis of stenosis severity . Overall , 95 % had coronary atherosclerosis , but only 39 % had 1 or more stenoses with ≥50 % narrowing . Of 30 siblings in whom the exercise test and perfusion scan were both abnormal , 70 % had ≥50 % stenoses . The mean stenosis in arteries that fed perfusion defects was only 43±31 % , and 68 % of such stenoses were < 50 % . However , in 71 % of all defects , the location matched arteries with the most severe stenoses . Conclusions —In asymptomatic persons with a family history of CAD , abnormal exercise scintigraphy identifies predominantly mild coronary atherosclerosis . Perfusion defects may be caused by coronary vasomotor dysfunction in addition to atherosclerotic plaque
Evidence on harms was limited , but direct harms seemed minimal ( for resting ECG ) or small ( for exercise ECG ) .
BACKGROUND Coronary heart disease is the leading cause of death in adults .
Screening for abnormalities by using resting or exercise electrocardiography ( ECG ) might help identify persons who would benefit from interventions to reduce cardiovascular risk .
PURPOSE To up date the 2004 U.S. Preventive Services Task Force evidence review on screening for  resting or exercise ECG abnormalities in asymptomatic adults .