Inappropriate Stress Testing in an Asymptomatic Patient with Sinus Bradycardia     

Inappropriate Stress Testing in an Asymptomatic Patient with Sinus Bradycardia     

A 71-year-old asymptomatic male was referred to a cardiologist for a treadmill stress test. The patient’s primary care physician sent him for this test after observing that patient had sinus bradycardia (heart rate of 44beats per minute). Results of the test revealed a ST segment depression at peak exercise. In response to these abnormal results, the patient was referred to us for an exercise gated sestamibi SPECT (single photon emission computed tomography) study. This revealed normal left ventricular systolic function and no evidence of ischemia. Stress testing is not indicated for asymptomatic arrhythmias. Therefore, we believe that the initial treadmill stress testing in this case was unnecessary and led to further superfluous testing.