Sensitivity and specificity of electrocardiographic diagnosis of ventricular motion disorders. Studies in patients recovered from myocardial infarction.
Angiographic-electrocardiographic correlations were studied in 253 patients with coronary arterial disease. Left ventriculograms were examined for various motion disorders (local hypokinesia, akinesia, dyskinesia or aneurysm, and generalized hypokinesia). Electrocardiograms were reviewed for the presence of Q waves indicative of transmural myocardial infarction and for the presence of upward convex ST-segment elevation of at least 2 mm. Of 27 consecutively studied subjects with normal coronary arteries and normal ventriculograms, none had Q waves, giving a specificity of 100% for the Q wave. Pathologic Q waves (greater than or equal to 0.04 second) were found in 20% (19) of 96 patients with coronary arterial disease having normal ventricular motion, reducing the specificity for the Q wave to 80% in patients with documented coronary disease. Of 157 patients with coronary disease and ventricular dyssynergy, 118 had pathologic Q waves, yielding a sensitivity of 75%. Concomitant Q waves plus 2 mm ST-segment elevation were present in 45 of the 118 postinfarction patients with ventricular dyssynergy, giving a sensitivity of 38%. The specificity of this combination in coronary patients was 84%.
D000790:Angiocardiography; D002932:Cineangiography; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D004562:Electrocardiography; D006322:Heart Aneurysm / Q000175:diagnosis; D006331:Heart Diseases / Q000175:diagnosis*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D009200:Myocardial Contraction; D009203:Myocardial Infarction