The role of 'ischemic ST-segment counterpoise' in rendering the response of exercise electrocardiogram falsely negative

Clinical Cardiology

Volumn 20, Issue 5, 1997, Pages 489-492

  Madias, John E ^a   Khan, Mujtaba ^b   Manyam, Bose ^b  

^a MOUNT SINAI HOSPITAL   (United States)

^b NONE

Author keywords

coronary artery disease; exercise electrocardiogram; myocardial ischemia; SPECT; thallium 201 scintigraphy

Indexed keywords

ACETYLSALICYLIC ACID; DILTIAZEM; ISOSORBIDE DINITRATE; THALLIUM 201;

ADULT; ARTICLE; CASE REPORT; CLINICAL FEATURE; CORONARY ARTERY DISEASE; CORONARY ARTERY SPASM; ELECTRIC POTENTIAL; ELECTROCARDIOGRAPHY MONITORING; EXERCISE ELECTROCARDIOGRAPHY; HUMAN; HYPERCHOLESTEROLEMIA; LABORATORY DIAGNOSIS; MALE; SINGLE PHOTON EMISSION COMPUTER TOMOGRAPHY; ST SEGMENT ELEVATION; STRESS;

EID: 0030950091     PISSN: 01609289     EISSN: None     Source Type: Journal    
DOI: 10.1002/clc.4960200517     Document Type: Article

References (15)

1. Epstein SE: Controversies in cardiology II: Value and limitations of the electrocardiographic response to exercise in the assessment of patients with coronary artery disease. Am J Cardiol 1978:42: 687-674
2. Zaret BL, Wackers FJ: Nuclear cardiology (first of two parts). N Engl J Med 1993:329:775-783
3. Madias JE, Sheth K: Ischemic ST-segment counterpoise: One mechanism of false electrocardiographic response to exercise stress testing. Am J Noninvas Cardiol 1994:8:194-199
4. Madias JE, Mahjoub M, Valance J: The paradox of negative exercise stress ECG/positive thallium scintigram: Ischemic ST-segment counterpoise as the underlying mechanism. J Electrocardiol 1996: 29:243-248
5. Mason RE, Likar I: A new system of multiple-lead exercise electrocardiography. Am Mean J 1966:71:196-205
6. Grant's Clinical Electrocardiography: The Spatial Vector Approach, 2nd Ed. (Ed. Beckwith JR), p. 3-183. New York: McGraw-Hill Book Co., 1970
7. Evans W: Cardiographic contrecoup in the course of cardiac infarction. Br Heart J 1963;25:713-725
8. Saikawa T, Abe M, Nakagawa M, Omura I, Takakura T, Horita S, Ito S, Takaki R, Ito M: The complete cancellation of abnormal Q waves due to an old anteroseptal infarction following subsequent acute posterior myocardial infarction. Jpn Heart J 1987;28: 805-810
9. Feldman RL, Hill JA, Whittle JL, Conti CR, Pepine CJ: Electrocardiographic changes with coronary artery spasm. Am Heart J 1983;106:1288-1297
10. Bell MR, Lapeyre AC III, Bove AA: Angiographic demonstration of spontaneous diffuse three-vessel coronary artery spasm. J Am Coll Cardiol 1989;14:523-527
11. Koh KK: Various 12-lead electrocardiographic findings of diffuse three-vessel coronary artery disease. Am Heart J 1992;123: 1187-1191
12. Epstein SE, Cannon RO III, Bonow RO: Exercise testing in patients with microvascular angina. Circulation 1991;83(suppl III): III-73-III-76
13. Yanowitz FG, Vincent GM, Lux RL, Merchant MH, Green LS, Abildskov JA: Application of body surface mapping to exercise testing: ST-isoarea maps in patients with coronary artery disease. Am J Cardiol 1982;50:1109-1113
14. Green LS, Abildskov JA: Clinical applications of body surface potential mapping. Clin Cardiol 1995;18:245-249
15. Couhan L, Krone RJ, Keller A, Eisenkramer G: Utility of lead V4R in exercise testing for detection of coronary artery disease. Am J Cardiol 1989;64:938-939