Can myocardial ischemia be recognized by the exercise electrocardiogram in coronary disease patients with abnormal resting Q waves?

• Published in: The American heart journal Vol. 111; no. 5; pp. 909 - 916
• Main Authors: Ahnve, Staffan, Savvides, Marios, Abouantoun, Sleiman, Atwood, J. Edwin, Froelicher, Victor
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.1986; Elsevier
• Subjects: Adult; Biological and medical sciences; Cardiology. Vascular system; Coronary Disease - diagnosis; Coronary Disease - diagnostic imaging; Coronary Disease - etiology; Coronary heart disease; Electrocardiography; Exercise Test; Heart; Heart - diagnostic imaging; Humans; Male; Medical sciences; Middle Aged; Physical Exertion; Radioisotopes; Radionuclide Imaging; Thallium; Physical exercise; Human; Electrodiagnosis; Abnormal Q wave; Ischemia; Myocardium; Cardiovascular disease; Exercise tolerance test; Scintigraphy; Coronary heart disease; ST change
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/0002-8703(86)90641-1

This study was performed in order to determine whether exercise-induced myocardial ischemia demonstrated by thallium-201 imaging could be detected by ST segment shifts in patients with abnormal Q waves at rest. Fifty-four patients with coronary artery disease and exercise-induced thallium-201 defects were compared to 22 patients with similar Q wave patterns but without thallium-201 exercise defects and to 14 normal subjects. Exercise data were analyzed visually in the 12-lead ECG and for spatial ST vector shifts. Both ST segment depression observed on the 12-lead ECG and spatial criteria were reasonably sensitive and specific for ischemia when the resting ECG showed no Q waves or inferior Q waves (range 69% to 93%). However, when anterior Q waves were present, ST segment shifts could not distinguish patients with ischemia from those with normal perfusion as determined by thallium imaging.