Monitored and Post-Exercise Two-Step Test

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Abstract
Silent coronary artery disease presents a problem of great magnitude, affecting an estimated 2 million persons or more yearly. The Master "two-step" test is of great value in the detection of such asymptomatic, ischemic heart disease. On the basis of long-term studies in 800 patients, it was substantiated that a negative twostep test virtually excludes significant myocardial ischemia. The response may be considered positive when ischemic depression of the RS-T segment occurs, or when a "j"-type RS-T depression is characterized by both a prolonged systole (QT ratio abnormal) and a duration prolonged in relation to this systole (QX/QT abnormal). The experienced physician can usually interpret these electrocardiographic changes by visual inspection. Monitoring of the two-step test has research potential, but at present is not as sensitive as the post-exercise electrocardiogram.