[69. Significance of work load electrocardiographic studies with reference to coronarographic findings]

The electrocardiography after work is assumed as an essential diagnostic aid in the evaluation of the chronic ischaemic heart disease. Differences in the diagnostic relevance of the results are related to the test method used. Therefore, comparison with the findings of selective coronary angiography is necessary, though the subject of ECG after work are functional changes, but that of coronary angiography are morphological ones. This study gives the comparison of both methods in 84 patients. In patients with coronary artery construction (greater than 75%) the diagnostic possibilities of ECG after work are limited. With regard to these patients it is pointed out that except of the obstruction of coronary arteries, as it is to be documented by selective coronary angiography, there are several further factors favourising coronary insufficiency, such as diminished perfusion of the peripheral coronary vessels, high levels of catecholamines, metabolic disturbances, diminished oxygen transport capacity or oxygen delivery. This may also explain the relatively low specifity of 60% of the ECG after work in the recognition of obstructive coronary artery disease.