Reciprocal ST segment depression in acute myocardial infarction

The significance of "reciprocal" ST segment depression and the utility of this finding in the electrocardiogram (ECG) of patients with myocardial infarction were studied in 100 cases of acute myocardial infarction. Out of these, 30 cases expired with 20 cases (66.6%) showing reciprocal ST depression in the ECG. In the remaining 70 cases, 24(34.3%) had reciprocal ST changes while 46(65.7%) had not. Twenty (83.3%) out of 24 cases had inferior wall infarction. The incidence of complications in the form of complete heart block and mortality was higher in the patients with reciprocal changes. The creatinine kinase levels were significantly elevated in patients with reciprocal changes than in the patients without. Predischarge treadmill test done in these cases having reciprocal changes showed positive stress tests. Coronary angiography was performed in the cases with reciprocal ST-T changes which revealed the presence of double-vessel disease or triple-vessel disease in most of these cases.