RT Journal Article
SR Electronic
T1 Exercise-induced ST segment elevation. Electrocardiographic, angiographic, and scintigraphic evaluation.
JF British Heart Journal
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 582
OP 588
DO 10.1136/hrt.43.5.582
VO 43
IS 5
A1 A Lahiri
A1 V Balasubramanian
A1 M W Millar Craig
A1 J Crawley
A1 E B Raftery
YR 1980
UL http://heart.bmj.com/content/43/5/582.abstract
AB Two hundred and fifteen patients with previous myocardial infarction were investigated between four and six months after the acute episode by computer assisted 12 lead exercise electrocardiography. Thirty-six (17%) out of this group showed ST segment elevation over the infarct zone, reflected by leads presenting with "QS" configuration. They were further investigated by serial thallium-201 scintigraphy, coronary arteriography, and left ventricular angiography. All showed left ventricular wall motion abnormalities and 89 per cent were diagnosed to have left ventricular "aneurysm" (dyskinesia and akinesia). In a further patient with a posterior aneurysm, the exercise-induced ST elevation could only be detected by using an oesophageal lead. We suggest that these changes reflect severe underlying left ventricular wall motion abnormalities in the presence or absence of reversible myocardial ischaemia. The mechanism of ST segment elevation in this situation, occurring in leads with a "QS" configuration, may be mechanical in the majority of the patients rather than due to reversible myocardial ischaemia.