ROLE OF LEFT VENTRICULAR FUNCTION EVALUATION IN NON SPECIFIC ECG ABNORMALITY

A total of 373 subjects [367 service persons and 6 civilians) with ECG abnormality were evaluated with maximal TMT exercise, 86 (23%) of them showing positivity. Subsequent assessment including radionuclide ventriculography and coronary arteriography wherever necessary revealed coronary artery disease in 31 (8.3%). The remaining 55 were further evaluated by 2D and M-Mode echocardiography for exclusion of any other cardiac disease responsible for the ECG abnormality as well as for assessment of LV performance. Seven subjects showed minor structural cardiac anomalies - MVP in 5 and HOCM in 2. The remaining 48 showed no significant difference in the measurements of LV posterior wall and IV septal wall thickness, mitral septal separation, mitral valve excursion velocities, LV end-systolic/end-diastolic internal diameters and calculated percent fractional shortening, LV end-diastolic, end-systolic and stroke volumes as well as ejection fraction, on comparison with 20 age matched controls. These 48 service persons, thus evaluated were considered to have no organic heart disease or cardiac function impairment and were cleared for all strenuous duties including flying of sophisticated aircrafts or posting to high altitudes.