Accuracy of Echocardiography in Women

By Frederick R. Jelovsek, M.D.,

A stress EKG or exercise EKG is known to be less accurate in women than men. A somewhat different study, an exercise echocardiogram, has been suggested to be a more accurate test for coronary artery disease in women. A recent study by Heupler at Cleveland Clinic, Prognostic implications of exercise echocardiography in women with known or suspected coronary artery disease. J Am Coll Cardiol. 1977 Aug; 30:414-20, indicates that echocardiographic evidence of ischemia (lack of oxygen to the heart) is a strong predictor of having an adverse cardiac event. It was more accurate than the exercise EKG.

In the exercise echocardiogram xray imaging is involved rather than just hooking up the electrodes of a standard EKG. This makes the test somewhat more expensive. It did, however, predict almost twice as many cardiac events such as myocardial infarction or even death.

If your doctor suspects you may have coronary artery disease, it is likely that one of the two studies will be ordered. Discuss this with the physician to see which is the best for you.