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      Exercise-Induced ST Segment Elevation in Q Wave Leads in Postinfarction Patients: Defining Its Meaning and Utility in Today’s Practice

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      S. Karger AG

      Exercise, ST elevation

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          Most attempts to identify qualitative and quantitative techniques for assessing myocardial viability and the likelihood of improved function after revascularization in patients with healed myocardial infarcts have focused on treatment strategies and prognosis. This review examines the true value of the electrocardiographic phenomenon of exercise-induced ST segment elevation (EISTE) in Q wave leads as a diagnostic tool for the assessment of myocardial viability. The prognostic potential and clinical utility of the EISTE phenomenon are inhibited both by the heart’s electrophysiologic response to exercise-induced metabolic and hemodynamic changes, and by the ECG’s limited facility in assessing myocardial preservation. The use of EISTE as an independent indicator for surgical intervention is proscribed by these limitations. The EISTE phenomenon could serve as a useful tool in the first line of discrimination in patients with healed Q wave myocardial infarction, and may justify further diagnostic work-up in patients under consideration for a revascularization procedure. In the era of sophisticated nuclear and echo techniques, accurate imaging studies should not be replaced by ECG analysis alone in the search for viable tissue, except when financial costs are of major importance.

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          Author and article information

          S. Karger AG
          September 2000
          02 October 2000
          : 93
          : 4
          : 205-209
          Mayo Physician Alliance for Clinical Trials,Mayo Clinic and Mayo Foundation, Rochester, Minn., USA
          7028 Cardiology 2000;93:205–209
          © 2000 S. Karger AG, Basel

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          Page count
          Tables: 1, References: 48, Pages: 5

          General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology

          Exercise, ST elevation


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