68% sn, 77% sp
Contraindications to Exercise<unk> 
Absolute
Myocardial infarction (within 2 days)
High-risk unstable angina
Uncontrolled cardiac dysrhythmias
Symptomatic aortic stenosis
Uncontrolled symptomatic heart failure
Acute pulmonary embolus or pulmonary infarction
Acute myocarditis or pericarditis
Acute aortic dissection
Relative
Baseline ST segment abnormalities
Left main coronary stenosis
Moderate stenotic valvular heart disease
Electrolyte abnormalities
Severe hypertension (>200 sys, >110 dia)
Tachydysrhythmias or bradydysrhythmias
HOCM
Mental or physical impairment
High-degree atrioventricular block
Absolute
Myocardial infarction (within 2 days)
High-risk unstable angina
Uncontrolled cardiac dysrhythmias
Symptomatic aortic stenosis
Uncontrolled symptomatic heart failure
Acute pulmonary embolus or pulmonary infarction
Acute myocarditis or pericarditis
Acute aortic dissection
Relative
Baseline ST segment abnormalities
Left main coronary stenosis
Moderate stenotic valvular heart disease
Electrolyte abnormalities
Severe hypertension (>200 sys, >110 dia)
Tachydysrhythmias or bradydysrhythmias
HOCM
Mental or physical impairment
High-degree atrioventricular block
Myocardial infarction (within 2 days)
High-risk unstable angina
Uncontrolled cardiac dysrhythmias
Symptomatic aortic stenosis
Uncontrolled symptomatic heart failure
Acute pulmonary embolus or pulmonary infarction
Acute myocarditis or pericarditis
Acute aortic dissection
Baseline ST segment abnormalities
Left main coronary stenosis
Moderate stenotic valvular heart disease
Electrolyte abnormalities
Severe hypertension (>200 sys, >110 dia)
Tachydysrhythmias or bradydysrhythmias
HOCM
Mental or physical impairment
High-degree atrioventricular block

The Bottom Line:
ETT has low sensitivity and specificity overall (especially for women) and as such is not a good test for patients in whom suspicion for ACS is high
ETT is safe in low-risk and select intermediate-risk patients as a way of determining who is at low risk for short term adverse events (and therefore can go home)
ETT does not have prognostic value for patients who return to the ED with concerning symptoms or ECG changes
ETT has low sensitivity and specificity overall (especially for women) and as such is not a good test for patients in whom suspicion for ACS is high
ETT is safe in low-risk and select intermediate-risk patients as a way of determining who is at low risk for short term adverse events (and therefore can go home)
ETT does not have prognostic value for patients who return to the ED with concerning symptoms or ECG changes
ACS - Stress Testing
Harbor Macros: EKG
ACS - Risk Stratification
Unstable Angina - NSTEMI Guidelines
Age adjusted D-dimer
ECGs by Diagnosis
Bubble study
ADDIE system