Transient myocardial ischemia in patients with chronic ischemic heart disease: Comparison of various clinical symptoms and methods of detection

Aim. To compare informative power of clinical and ECC signs of myocardial i schemia with different methods of its detection in patients with angiograph ically proven coronary heart disease. Material. Fifty two patients with ste noses >70% in at least 1 major coronary artery. Methods. Twelve lead ECGs d uring treadmill exercise tests and ambulatory 24-hour ECC recordings were o btained after at least 1 week drug free period. Severity of angina was asse ssed by 3 grade scale with which the patients were accustomed prior to the study. Results. Forty nine patients had either clinical symptoms or signs o f myocardial ischemia on treadmill ECC and 49 of them had both. Maximal ST- segment depression was observed in lead II in most of the patients. During 24-hour ECC monitoring clinical or ECC signs of myocardial ischemia were re gistered in 38 patients while 14 had no signs of ischemia. Conclusion. Clin ical and ECC signs of myocardial ischemia have similar informative power. T readmill exercise test with continuous registration of 12-lead ECG detects myocardial ischemia in most patients with coronary artery stenoses. Twenty four hour ECC monitoring is less informative for detection of transitory my ocardial ischemia.