The role of ambulatory ST-segment monitoring in the diagnosis of coronary artery disease: comparison with exercise
European Heart Journal
|February 1, 1987
Summary
Ambulatory ST-segment monitoring effectively detects coronary artery disease, matching exercise stress testing accuracy. This method also identifies patients with coronary artery spasm and normal coronary arteries.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Clinical Medicine
Background:
- Coronary artery disease (CAD) diagnosis relies on various methods.
- Exercise testing is a common diagnostic tool for CAD.
- Ambulatory ST-segment monitoring offers continuous electrocardiographic assessment.
Purpose of the Study:
- To evaluate the diagnostic value of ambulatory ST-segment monitoring for coronary artery disease.
- To compare its efficacy against exercise testing and thallium scintigraphy.
- To assess its ability to detect coronary artery spasm.
Main Methods:
- One hundred consecutive patients with chest pain underwent exercise testing and coronary arteriography.
- Forty-seven patients also had thallium-201 radioisotope imaging.
- Forty-eight hours of ambulatory ST-segment monitoring was performed.
Main Results:
- Ambulatory monitoring showed 77% sensitivity for CAD detection, comparable to exercise testing (73%).
- Three-vessel disease was detected more efficiently (80% sensitivity) than single-vessel disease (50%).
- Thallium scintigraphy identified defects in patients without ST-segment changes, and one case of coronary spasm was noted.
Conclusions:
- Ambulatory ST-segment monitoring is a valuable tool for diagnosing coronary artery disease, with efficacy similar to stress testing.
- It aids in identifying patients with coronary spasm and normal coronary arteries.
- Left ventricular function impacts the absence of ST-segment changes, while previous myocardial infarction does not affect results.
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