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Related Experiment Videos

Post exercise T wave changes in patients with normal and abnormal coronary arteriogram

G Forssel, R Jonasson, C Landou

    Acta Medica Scandinavica
    |January 1, 1981
    PubMed
    Summary

    An abnormal ST reaction on post-exercise electrocardiograms (ECGs) can indicate significant coronary artery disease. Combining ST reaction with T wave changes in lead V2 improves detection sensitivity in effort angina patients.

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    Area of Science:

    • Cardiology
    • Diagnostic Imaging
    • Exercise Physiology

    Background:

    • Effort angina is often diagnosed using exercise electrocardiography (ECG).
    • Identifying significant coronary artery obstructions (diameter reduction ≥50%) is crucial for patient management.
    • Standard ECG criteria may not always accurately detect coronary artery disease.

    Purpose of the Study:

    • To evaluate the diagnostic accuracy of post-exercise ECG criteria for detecting significant coronary artery obstructions in patients with effort angina.
    • To assess the utility of ST-T wave changes, specifically in lead V2, for improving diagnostic sensitivity.

    Main Methods:

    • Compared pre- and post-exercise ECGs in 81 patients with effort angina (15 normal, 66 abnormal coronary arteriograms).
    • Analyzed abnormal ST reaction and T wave amplitude changes in lead V2 (2-4 min post-exercise).

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  • Excluded ECGs with other known causes of ST-T changes.

    • Main Results:

    • Abnormal ST reaction alone had 56% sensitivity and 100% specificity for significant coronary obstructions.
    • Adding a ≥20% reduction in T wave amplitude in lead V2 increased sensitivity to 82% and decreased specificity to 92%.
    • No patients with normal arteriograms showed an abnormal ST reaction; only 1/13 had significant T wave reduction.

    Conclusions:

    • An abnormal ST reaction post-exercise is highly specific but moderately sensitive for significant coronary obstructions.
    • Incorporating T wave amplitude changes in lead V2 significantly enhances the sensitivity of exercise ECG for detecting coronary artery disease in effort angina.
    • The T V2 reaction warrants further study in angina patients with non-diagnostic ST reactions.