%0 Journal Article %A Salima Qamruddin %T False-Positive Stress Echocardiograms: A Continuing Challenge %D 2016 %J Ochsner Journal %P 277-279 %V 16 %N 3 %X Background: Stress echocardiography is an integral test in the cardiac diagnostic laboratory and has high sensitivity and specificity. Despite the excellent specificity of stress echocardiography, we continue to see a subset of patients with false-positive tests (defined as <50% diameter stenosis on subsequent coronary angiography). These false-positive findings present a management challenge because it remains unclear if and how to treat these patients.Methods: This article reviews relevant clinical studies and their outcomes.Results: Studies suggest that a group of patients develops a hypertensive response to exercise and therefore may have false-positive stress echocardiography. Hence, superior blood pressure control prior to stress echocardiography may prevent some false-positive tests. In addition, a subset of patients has microvascular abnormalities, vasomotor changes, endothelial dysfunction, and/or small vessel coronary disease that can lead to false-positive stress echocardiography.Conclusion: The evidence is insufficient to state that a false-positive stress echocardiography in the absence of obstructive coronary artery disease portends a poor outcome, but considerable evidence shows that some of these patients have microvascular abnormalities and endothelial dysfunction and consequently may benefit from aggressive medical management and further testing. %U https://www.ochsnerjournal.org/content/ochjnl/16/3/277.full.pdf