Stress Testing: Principles and Practice, 5th ed.

Ellestad MH. New York, NY 10016, Oxford University Press Inc, 2003, hardcover, 557 pp, illus, ISBN: 0-19515928-4, $79.95.

This textbook is the first new edition since 1975 and provides information primarily for cardiologists on the history, indications, mechanics, and interpretation of stress tests. Although 3 writers make contributions to the text, Ellestad has written most chapters himself and uses his own experience to support many of his statements and protocols.

The book includes 24 chapters ranging from the history of stress testing and the physiology of exercise testing to more direct instructions on how to test patients following myocardial infarction, cardiac surgery, heart failure, silent ischemia, and other exercise abnormalities. Chapters on electrocardiogram interpretation, radionuclide techniques, and medication-induced exercise effects are also included, in general, the text covers the breadth of cardiac stress testing; however, it would be improved by the addition of more information on pulmonary exercise testing, which, in nay opinion, allows clinicians to provide a more through examination and better exercise prescriptions. The book contains black-and-white illustrations, predominantly line drawings that often appear hand drawn.

Most chapters are short and easy to read. However; the references in several chapters are somewhat old for such a dynamic area. It appears that little updating of the hook's content has occurred since the last edition in 1975, particularly regarding sports applications and the physiology, of ischemia and heart failure. Rather than providing a clear summary of the evidence, the material used throughout tends to support the author's own experience. More current references are provided in the areas of stress echocardiography and predictive implications of electrocardiographic abnormalities.

The main audience for Ibis text will likely continue to be cardiologists. The information would be too advanced for most physical therapist students, but parts may be or" value as reference material for more experienced clinicians who perform or interpret stress tests regularly.

Anne K Swisher PT. PhD CCS West Virginia University Morgantown, WVa

Dr Swisher is Associate Professor in the Division of Physical Therapy and teaches in the area of cardiopulmonary, physical therapy and exercise physiology. She is also active in research in pulmonary disease and muscle dysfunction.