[Electrocardiography and quantitative levocardiography in chronic transmural infarct. A correlative study]

For evaluation of a connection between the electrocardiographic diagnosis and localisation of chronic infarction and the angiographic results left ventriculography data of 97 patients with coronary heart disease were assessed quantitatively according to the method of Mathes. According to electrocardiographic criteria of infarction six subgroups were distinguished: anteroseptal, anterior, anterolateral, inferior, inferiolateral, and posterolateral. Asynergies were demonstrable in 87% of patients with infarct electrocardiograms, normal ventricular function was seen in 80% of patients without infarct ECG. Asynergies were seen in 75% of electrocardiographically diagnosed anterior wall infarcts and in 92% of posterior wall infarcts. The sensitivity of the ECG in chronic infarction was 83%, the specificity 84%. Pronounced differences in the number of involved segments were found between inferior and inferiolateral infarction. In contrast, no clear-cut differentiation of electrocardiographic findings judged by segmental involvement in the left ventriculography was seen for the anterior wall. The extent of the anterior wall infarction diagnosed by electrocardiography did not correlate with results of left ventriculography. The ECG is a suitable means for detection of segmental disturbances of contraction also in the chronic infarction stage. However, localisation and extent of the lesion can only be assessed within limits.