ABSTRACT

Aims:

The etiology and pathophysiology of precordial ST segment depression seen in inferior myocardial infarction have been investigated in numerous studies. Still there is much debate going on about its clinical implications. This study will explore the correlation between precordial ST segment depression in acute inferior myocardial infarction and concomitant coronary artery pathology. We focus on this subject for the reason that it may help clinicians in treatment planning and stratification of patients into relative lowrisk and high risk groups.

Methods:

Medical records of 77 patients who have been diagnosed with acute inferior myocardial infarction were retrospectively examined. Coronary angiography had been performed on all of them for the indication of inferior myocardial infarction. Patients’ first 24 hour ECGs were scanned and classified into 3 groups. Group 1 consists of patients without any precordial ST segment depression; Group 2 consists of patients with maximum precordial ST segment depression in leads V1 to V3; Group 3 consists of patients with maximum precordial ST segment depression in leads V4 to V6. The presence of precordial ST segment depression and its correlation with the anatomy of left anterior descending artery and multivessel disease were examined to determine a statistical significance.

Results:

When the data for 3 groups was examined in regards to occlusion of left anterior descending artery (>50%), no statistical significance was found (p=0.439). Likewise, the presence of precordial ST segment depression was not significant for multivessel disease in any of the groups (p=0.849).

Conclusion:

Taking the amount of inconsistent results that are being gathered on this subject into account, our interpretation in respect of these results is that it would not be appropriate to make an inference about coronary occlusion based on the presence and distribution of precordial ST segment depression before coronary angiographic procedures. Yet, in the light of previous researches and the interpretation that precordial ST segment depression is correlated to cardiac reserve and mortality, the subject of precordial ST segment depression in inferior myocardial infarction still carries great importance.