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[Angina with long-standing coronary T waves].

N Hamashige1, Y Doi, H Odawara

  • 1Department of Medicine and Geriatrics, Kochi Medical School, Nankoku.

Journal of Cardiology
|September 1, 1988
PubMed
Summary

Long-standing coronary T waves, especially alone, indicate significant coronary artery stenosis and unstable angina. Cardiac events occurred only when patients stopped medication, irrespective of stenosis severity.

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Area of Science:

  • Cardiology
  • Clinical Electrocardiography
  • Ischemic Heart Disease

Background:

  • This study evaluates the clinical significance of persistent coronary T waves (≥24 hours) without abnormal Q waves in patients experiencing angina.
  • The research categorizes patients into two groups: Group A (ST elevation followed by coronary T waves) and Group B (coronary T waves alone).

Observation:

  • Patients presented with rest angina, often indicative of unstable angina, and a history of effort angina was common.
  • Elevated serum creatine phosphokinase (CPK) levels were observed in a significant percentage of both groups, with no correlation to T wave changes.
  • Coronary angiography revealed a higher incidence of severe coronary artery stenosis (>50%) in Group B compared to Group A.

Findings:

  • Group B, characterized by coronary T waves alone, showed a greater prevalence of significant coronary artery stenosis (77%) than Group A (27%).

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  • Angioplasty was more frequently performed in Group B (38%) than in Group A (9%).
  • During a 27-month follow-up, cardiac events (unstable angina, sudden death) occurred only in patients who discontinued their medications, regardless of stenosis severity.

    • Implications:

    • Coronary T waves alone may be a stronger indicator of severe coronary artery disease than when preceded by ST elevation.
    • Medication adherence is critical for preventing adverse cardiac events in patients with these electrocardiographic findings.
    • Further research may refine risk stratification and management strategies for patients with persistent coronary T waves.