[The angiographic features of exercise-induced ST-segment elevation in patients without myocardial infarction].
OBJECTIVE
To explore the incidence and angiographic features of exercise-induced ST-segment elevation in patients without prior myocardial infarction.


METHODS
Exercise-induced ST-segment elevation occurred in 15 out of 4601 consecutive patients without prior myocardial infarction underwent treadmill exercise testing during a 2-year period. The coronary angiographic features of the 15 patients (13 males, aged between 40 - 75 years) were analyzed.


RESULTS
Coronary angiography revealed one hemodynamically relevant stenotic vessel in 6 patients, two hemodynamically relevant stenotic vessels in 6 patients, three hemodynamically relevant stenotic vessels in 3 patients. Left anterior descending (LAD) coronary artery was affected in 12 patients. Left main coronary artery (LMCA) stenosis was evidenced in 1 patient and right coronary artery stenosis in 7 patients. Severe (90% - 100%) occlusions were visualized in 8 out of 13 patients with LAD or LMCA lesions. Elevated ST-segment leads were consistent with the ischemic area where the blood supply of myocardium was affected by diseased vessels.


CONCLUSIONS
The incidence of exercise induced ST-segment elevation in patients without prior myocardial infarction is very low and mostly due to severe fixed coronary artery stenosis, especially in LAD. The location of ischemic myocardium can be suggested by ST-segment elevation leads during exercise.
Yan
Yan
Y
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Li
Gao-ping
GP
Li
Jing-xia
JX
Jing
Huai-gen
HG
Qian
Ju-ying
JY
Zhu
Wen-qing
WQ
Ge
Jun-bo
JB
Lin
You-shan
YS
Zhu
Jun-ren
JR
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged