Significance of exercise induced U wave inversion as a marker for coronary artery disease.
Exercise stress testing for detecting inducible ischaemia was first introduced in the 1950s and remained one of the only methods of stressing the heart for years to come. The presence of inducible ischaemia was assessed by ECG changes during exercise apart from other factors, namely, duration of exercise, blood pressure and heart rate response, metabolic equivalents achieved, etc. With the emergence of other tests to look for inducible ischaemia, for example, dobutamine stress echocardiography and myocardial perfusion scanning and also as the threshold for invasive evaluation has decreased, unusual and infrequently encountered ECG changes are not looked for during exercise stressing with the same degree of diligence. The authors describe below the case of a 49-year-old male whose left anterior descending artery stenosis was diagnosed on exercise stress test on the basis of a negative U wave.
Department of Cardiology, Heart and Lung Centre, NewCross Hospital, Wolverhampton, UK. drshelley@hotmail.co.uk
Shelley
S
Raveendran
Rebecca
R
Hadfield
Sanjiv
S
Petkar
Nadim
N
Malik
D015415:Biomarkers; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography
D015415:Biomarkers