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Master vs Physiologic Stress Tests

David H. Spodick, MD

JAMA. 1975;234(7):745-746.

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The Master test probably would never have been developed if stress testing had begun under the aegis of modern cardiologists. Based on an old Harvard Fatigue Laboratory test, the contemporary "double Master" and particularly the "augmented Master"¹ represent ultimate load adjustments in a sequence spanning nearly a half-century. The prescribed numbers of trips in the original "single Master"² were arrived at by its originator in a more or less ad hoc fashion, rather than by the kind of physiologic design favored by contemporary cardiologists.^3-6 They, certainly, would not now sanction the superficially reasonable, but physiologically unwarranted, prescription of trips according to body weight. Even more ad hoc were the development—in response to demands for greater stress levels—of the "double" and "augmented" tests (why exactly double and not, say, 1.5, 2.5, or 3 times the number of trips? Why augmented by 15% and not 10% or 20%?). All . . . [Full Text PDF of this Article]

Author Affiliations
Department of Medicine Tufts University School of Medicine Boston

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