The utility of combined cardiopulmonary exercise stress testing in the evaluation of pediatric patients with chest pain.

Only 1% of patients previously undiagnosed with heart disease had an abnormal stress test and an incidental anomaly on ECHO. These ECHO anomalies were unlikely to be the cause of chest pain. Furthermore, since the majority of abnormal stress tests were secondary to a pulmonary cause, a complete cardiopulmonary EST may be an effective screening tool for certain patients presenting with chest pain. Our study emphasizes the need for performing a complete cardiopulmonary EST instead of an isolated cardiac stress test to maximize diagnostic efficiency and yield.