PERCEPTION OF CHEST PAIN DURING EXERCISE TESTING IN PATIENTS WITH CORONARY-ARTERY DISEASE

Psychophysical scaling of symptoms or discomfort during exercise testi ng has evolved as an important adjunct to the study of therapeutic int erventions in heart disease. One of the major shortcomings of clinical exercise testing, however, has been the assessment of chest pain. Alt hough the presence and characteristics of chest pain have important di agnostic, prognostic, and therapeutic implications, few studies in the literature adequately address chest pain responses to exercise. Clini cal trials using exercise as an efficacy parameter frequently use only a single descriptive testing endpoint, such as ''moderate'' angina. M ethods of scaling chest pain during exercise testing are underutilized . Of the several grading systems that have been used, the 0-10 scale d eveloped by Borg has been the most common. It is preferable for patien ts to relate chest pain sensations during exercise testing to those ex perienced during daily activities, and treadmill experience improves t he reliability and reproducibility of patient responses. This paper ex amines the methodology and clinical applications of quantifying chest pain during exercise.