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[ST elevation during ergometric test: correlation with coronary angiography]

L Irace1, D Aquino, A Scialdone

  • 1Facoltà di Medicina e Chirurgia, II Università degli Studi di Napoli.

Minerva Cardioangiologica
|May 1, 1993
PubMed
Summary

ST elevation during stress tests in patients with exertional angina, without prior heart attack, strongly indicates significant left anterior descending artery stenosis. This finding is crucial for diagnosing critical coronary artery disease.

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Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Exercise Physiology

Background:

  • ST elevation on ergometric stress tests (EST) is rare, especially in typical exertional angina.
  • Its occurrence is more common in patients with prior myocardial infarction or variant angina.
  • The pathogenesis of ST elevation in exertional angina without infarction is not well understood.

Purpose of the Study:

  • To investigate the significance of ST elevation during EST in patients with exertional angina.
  • To determine the correlation between ST elevation and coronary artery disease, specifically left anterior descending (LAD) artery stenosis.
  • To identify predictors of significant LAD stenosis based on EST findings.

Main Methods:

  • Studied 49 patients with exertional angina and no history of myocardial infarction or left ventricular asynergy.

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  • Performed symptom-limited EST with continuous 12-lead ECG monitoring.
  • Conducted coronary angiography to assess coronary artery disease severity and location.

    • Main Results:

    • All patients had coronary artery disease; 10.1% showed ST elevation during EST.
    • ST elevation in leads V1-V2 was consistently associated with LAD artery stenosis.
    • ST elevation occurred in 55.5% of patients with LAD stenosis >= 90%, particularly when located before the first diagonal branch.

    Conclusions:

    • ST elevation in V1-V2 during EST in patients with exertional angina and no infarction is a strong predictor of critical LAD stenosis.
    • This ECG finding aids in identifying patients requiring urgent intervention for significant coronary artery disease.