RT Journal Article SR Electronic T1 Abnormal left ventricular wall movement in patients with chest pain and normal coronary arteriograms. Relation to inferior T wave changes and mitral prolapse. JF British Heart Journal JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 385 OP 391 DO 10.1136/hrt.41.4.385 VO 41 IS 4 A1 D G Gibson A1 D J Brown YR 1979 UL http://heart.bmj.com/content/41/4/385.abstract AB Left ventriculograms of 45 patients with angina and normal coronary arteriograms were digitised frame by frame in order to detect regional abnormalities of wall movement. Though left ventricular pressures, end-diastolic volume, and ejection fraction were normal in all, regional outward movement during early systole was present in 10 patients, and abnormal inward wall movement during isovolumic relaxation also in 10, involving the apex or inferior surface. Both were present together in 8 patients, and affected segments showed normal amplitude and peak velocity of movement during ejection. These disturbances of wall movement were associated with inferior T wave changes on the electrocardiogram, and mitral prolapse, particularly when the latter resulted from delayed movement of the valve during ejection. It is suggested that the onset of contraction is delayed in affected areas, but that it proceeds normally thereafter. The resulting persistence of tension into the period of relaxation of the remainder of the ventricle may interfere locally with coronary flow, particularly during tachycardia, thus causing manifestations of regional ischaemia.