title: Importance of notching and slurring of the resting QRS complex in the diagnosis of coronary artery disease.
abstract: Data on the correlation of coronary artery disease (CAD) and electrocardiographic findings are, except for Q waves, still controversial. The purpose of this study was to determine whether QRS complex notching and slurring (N&S) is of significant value as a diagnostic discriminator in the detection of CAD. This study comprised 500 consecutive patients aged between 24 and 81 years (mean, 53.4 years) who underwent coronary angiography because of chest pain. Patients were evaluated for CAD, angiographic evidence of myocardial infarction (MI), N&S, and abnormal Q waves. Of these 500 patients, 418 had CAD, and 370 of these had significant (> or = 70%) coronary artery obstruction. The remaining 82 patients had normal coronary arteries. The data revealed that the distribution of N&S in the patients with or without CAD was similar in both the inferior and limb leads (P > .05). But the percentage of N&S in more than two contiguous limb leads was higher in the patients with CAD than in the patients without CAD. Notching and slurring in at least one limb lead was found to be of no value in the diagnosis of MI, of wall motion abnormalities, and of significant obstruction. Notching and slurring in the anterior leads is more sensitive but less specific than abnormal Q waves in the same leads in the detection of significant obstruction, anterior MI, and anterior wall motion abnormalities. Notching and slurring in the anterior leads has as much importance as abnormal anterior Q waves in the detection of angiographic evidence of anterior infarct, of anterior wall motion abnormalities, and of significant coronary artery obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Cardiology, University of Ankara, Faculty of Medicine, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Alpman
authors.forename: M
authors.initials: M
authors.lastname: Güldal
authors.forename: B
authors.initials: B
authors.lastname: Berkalp
authors.forename: E
authors.initials: E
authors.lastname: Diker
authors.forename: C
authors.initials: C
authors.lastname: Erol
authors.forename: D
authors.initials: D
authors.lastname: Oral
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged