[Post-infarction recurrent myocardial ischemia. Characterization with Holter ECG and exercise test].
In order to characterize postinfarction ischemia, 68 patients were studied by 24 hours Holter-monitoring and exercise testing. Twenty-four (35%) patients in Holter-monitoring and 26 (38%) in exercise testing had transient ischemic episodes. A significant coefficient of agreement was found between both tests. Nineteen (79%) of the patients had only silent ischemic episodes in Holter monitoring, and 87% of all episodes were asymptomatic. Twenty-two (87%) of the patients during positive exercise testing had silent ischemia. Eleven (46%) patients had transient ischemia at low and also at high heart-rates. Ten (37%) patients had ischemic episodes at lower charges than 100 watts, and all of them had more than 60 min of total ischemic burden in Holter-monitoring. A significant correlation was found between total ischemic burden and maximum ST segment shifts. The number of ischemic episodes were significantly higher during morning hours. A significantly higher rate of ventricular extrasystoles was found in recurrent ischemic patients, however, no difference was found in complex arrhythmias. After 1 year follow-up, 3 residual ischemic patients have died. The morbidity-calculated relative-risk is 13.9 times higher in patients with recurrent ischemia.
García Barreto
D
D
Instituto de Cardiología y Cirugía Cardiovascular, Habana, Cuba.
Valdesuso Aguilar
R
R
Rivas Estany
E
E
Hernández Acosta
K
K
González León
P
P
Alvarez Ginzo
A
A
D000328:Adult; D000368:Aged; D005117:Cardiac Complexes, Premature / Q000175:diagnosis / Q000209:etiology; D003327:Coronary Disease / Q000175:diagnosis* / Q000209:etiology; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D012008:Recurrence
Isquemia miocárdica recurrente postinfarto. Caracterización por ecg-holter y prueba de esfuerzo.