[Exercise electrocardiogram coupled with right cardiac microcatheterization after myocardial infarct. Correlations...

This work is based on the results of a systematic scheme of investigation consisting of an exercise test on the bicycle ergometer with analysis of the ECG and of the pulmonary arterial pressure measured by cardiac micro-catheterisation, and of ventricular and coronary arteriography; 60 patients were investigated in this way after the third month following a myocardial infarction. After an anterior infarction, there is no significant correlation between the ECG changes and the coronary arteriogram. An elevation of the tracing is often (but not always) indicative of akinesia or dykinesia of the ventricle. After a posterior infarction, depression of the trace in leads which were initially normal indicates extension of the coronary lesions in 9 cases out of 10. It, is, however, possible for a tight stenosis on the anterior descending artery to exist with no changes on the ECG. A highly significant (p less than 0.001) and strong (r=0.83) correlation between an index of haemodynamic severity as defined by variations in the pulmonary arterial pressure on exercise and by the score on coronary arteriography, allows us to define certain indications for coronary arteriography and ventriculography after infarction.