Correlation between angiographic and ECG signs location in unstable angina

The authors examine if the modifications of the ventricular repolarisation in patients with unstable angina have a value in localizing the site of the coronary stenoses. The relationship between ECG changes and angiographic abnormalities, as yet unrecognized, is studied in 200 patients. The subendocardial signs have little value in predicting the place of the narrowings, they often involve the lateral leads and join with diffused coronary lesions. Subepicardial ECG changes, however, have a good value for prediction: the involvement of inferior leads implies a right coronary stenosis, and that of septal leads a left anterior descending stenosis. The importance of a systematic recording of these ECG changes in unstable angina before performing coronary angiography is discussed. They should be able to specify the ischemic area of the myocardium and then help clinicians to decide when coronarography (and bypass surgery) is indicated.