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[ST segment elevation in the ECG stress test in coronary disease]
1Ustav fyziologie a patofyziologie Zdravotnĕ sociální fakulty Ostravské univerzity, Ostrava.
Vnitrni Lekarstvi
|May 15, 2003
Summary
A negative exercise stress test after myocardial infarction predicts survival. ST-segment elevation during exercise testing in patients post-myocardial infarction indicates a poor prognosis and need for further cardiac evaluation.
Area of Science:
- Cardiology
- Exercise Physiology
Context:
- Investigated 122 men post-myocardial infarction (MI) between 1986-1991.
- Mean age 56 years, with follow-up of at least 24-35 months.
Purpose:
- To evaluate the prognostic value of exercise stress testing in men after myocardial infarction.
- To identify patient subgroups requiring priority for further cardiac investigation and intervention.
Summary:
- Symptom-limited ergometric tests were performed 18 days post-MI.
- Negative tests (55%) had no mortality. Positive tests (28%) had 6% mortality.
- ST-segment elevation (17%) correlated with impaired ventricular motility, low ejection fraction (32%), and 62% mortality.
Impact:
- Exercise stress test results, particularly ST-segment elevation, are critical indicators of prognosis post-MI.
- Patients with ST-segment elevation require priority for coronary angiography and potential revascularization.
- ST elevation without pathological Q waves may indicate coronary spasm or stenosis, also warranting angiographic evaluation.