PMID: 6411261Sep 3, 1983Paper

"Reciprocal" depression of the ST segment in acute myocardial infarction

British Medical Journal
K JenningsD G Julian

Abstract

In acute myocardial infarction depression of the ST segment in leads distant from those showing ST elevation has been considered to be "reciprocal" but might reflect local ischaemia. To examine this possibility 103 consecutive patients who underwent exercise testing early after myocardial infarction were reviewed. Treadmill exercise testing was performed a mean of 12 (range 5-30) days after infarction using a limited Naughton protocol. Thirty five (34%) of the patients had had reciprocal change, defined as greater than or equal to 1 mm ST depression in leads remote from the site of the infarct, within 48 hours of infarction. Twenty two (63%) of the 35 patients developed exercise induced ST depression in the leads previously showing reciprocal change. Coronary artery disease was assessed in 10 of these patients by arteriography and in four at necropsy: all but one had stenosis of greater than or equal to 50% in a coronary artery supplying the reciprocal territory in addition to the disease in the vessel to the infarct site. Of patients with reciprocal ST depression, 23.5% experienced nonfatal reinfarction, pulmonary oedema after discharge, or death compared with only 9.5% of patients without reciprocal ST depression. Eight (23.5...Continue Reading

References

Aug 1, 1979·Circulation·R F DunnR Uren

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Citations

Nov 1, 1985·British Heart Journal·O OdemuyiwaR Hall
May 6, 2014·The American Journal of Emergency Medicine·Getaw Worku HassenHossein Kalantari
Sep 1, 1984·Journal of the American College of Cardiology·M HaraphongseB I Jugdutt
Mar 27, 2004·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Thomas K RoR Parker Ward
Nov 1, 1986·Diabetic Medicine : a Journal of the British Diabetic Association·G A OswaldJ S Yudkin
Nov 27, 2007·Circulation Journal : Official Journal of the Japanese Circulation Society·Marcin KozuchWlodzimierz Jerzy Musial

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