title: Significance of exercise-induced ST-segment deviation in right-sided chest leads in the diagnosis of right ventricular ischemia.
abstract: Seventy-three patients were subjected to bicycle ergometry and exercise-induced ST-segment changes in right-sided chest leads were correlated with changes in conventional leads. ST-segment elevation in right-sided chest leads was found to be more frequent than ST-segment depression. ST-segment elevation in right-sided chest leads was commonly reciprocal to ST-segment depression in leads V3 to V7, indicating that this change is usually secondary to left ventricular subendocardial ischemia, rather than to right ventricular ischemia. ST-segment depression in right-sided chest leads was mostly a primary change indicating right ventricular subendocardial or posterior wall ischemia. It is, therefore, felt that ST-segment depression in right-sided chest leads is more sensitive and specific for right ventricular ischemia than ST-segment elevation in these leads.
authors.affiliation: Department of Medicine, J.L.N. Medical College and Hospital, Ajmer, Rajasthan, India.
authors.forename: S
authors.initials: S
authors.lastname: Pamecha
authors.forename: S R
authors.initials: SR
authors.lastname: Mittal
authors.forename: M
authors.initials: M
authors.lastname: Lalgarhia
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000295:instrumentation / Q000592:standards*; D004566:Electrodes / Q000592:standards*; D005069:Evaluation Studies as Topic; D005080:Exercise Test / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012680:Sensitivity and Specificity; D016278:Ventricular Function, Right