[Electrocardiographic manifestations of myocardial ischemia]

The ECG is an indirect and non-specific test of myocardial ischemia, which means that the limits in respect to sensitivity and specificity must be evaluated. The dynamic Holter ECG is a useful method, particularly if pain appears during the recording time. The exercise test as an example of additional stress is of great general interest, especially in man; stress-testing is particularly useful in explaining the origin of atypical anginal pain. Hence the interpretation criteria must be closely followed rather than enlarged as long as the indication for diagnostic coronary-angiography is limited by the result of exercise testing. When other non-invasive methods are not readily available it should be possible to broaden the diagnostic criteria to increase sensitivity; by the same token, the number of false positive tests will be controlled by these complementary non-invasive methods.