Symptomless myocardial ischemia: Feasibility of diagnostic mistakes

Aim. To examine feasibility of ST segment depression on ECG in treadmill ex ercise test and 24-h ECG monitoring in subjects with coronarographically in tact coronary arteries. Materials and methods. 9 males aged 41 to 52 years with chest pains unrelat ed to muscular load. They had neither stenosis of coronary arteries, nor ar terial hypertension, valvular defects, disturbance of electrolyte metabolis m. All of them have undergone treadmill exercise test and 24-h ECG monitori ng. Results. The exercise test provoked chest pain in none of the examinees. ST segment was depressed in one patient. 24-h monitoring registered depressio n of ST segment in one more patient. The rest 7 patients showed no changes in ST segment either in exercise test or 24-h ECG monitoring. Conclusion. It is confirmed that typical ischemic ECG changes (horizontal d epression of ST segment) in healthy persons can occur and may be mistaken f or silent myocardial ischemia.