Silent Coronary Artery Disease

Every person 35 years of age or older should have an annual physical examination, with a chest x-ray and an electrocardiogram. Even if the latter is negative and the patient has no complaints, he should be given the two-step or an equivalent exercise test. A positive test result suggests myocardial ischemia, with increased risk of cardiac morbidity or death, even in the asymptomatic person. A negative response has been statistically proved to indicate a favorable prognosis.