Reciprocal ST segment changes in acute inferior myocardial infarction: clinical, haemodynamic and angiographic implications

Abstract

Reciprocal ST segment changes are frequent during acute inferior myocardial infarction, yet their significance remains controversial. In order to investigate the implications of these changes, the ECG obtained on admission for 83 patients with acute inferior myocardial infarction was compared with the clinical course and the results of angiographic and coronary arteriographic studies performed an average of 3 weeks after the onset of symptoms. Group 1 consisted of 59 patients with at least 1 mm of horizontal on downsloping ST segment depression in at least 1 of leads V1 to V4. Groups 2 consisted of 24 patients without precordial ST depression in this area. Group 1 patients were generally older than group 2 patients (59.6 +/- 6.4 versus 54 +/- 5.3 yr, P less than 0.01) had higher total creatine kinase (CK) levels and MB fractions (1835 +/- 940 versus 875 +/- 305, P less than 0.01, 269 +/- 102 versus 95 +/- 35 for MB fraction) and more complications during the hospital course (80% versus 38% P less than 0.01) and greater left ventricular dysfunction (ejection fraction 52.2 +/- 6% for group 1 versus 59.2 +/- 7% for group 2; cardiac index 2.75 +/- 0.41 min-1 m-2 for group 1 versus 3.25 +/- 0.31 min-1 m-2 for group 2 P less than 0.005). No difference was observed on biplane angiography as far as left ventricular wall kinesis was concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

Subepicardial burn injuries in bullfrog heart induce electrocardiogram changes mimicking inferior wall myocardial infarction

“…2 , right). These findings also mimicked the reciprocal ST segment changes frequently observed in human inferior wall myocardial infarction [ 5 , 21 ]. In general, the presence of reciprocal changes in ECG reflects the extent of myocardial ischemia [ 8 ] and supports the diagnosis of acute myocardial infarction [ 3 , 24 ].…”

Reciprocal ECG change in reperfused ST-elevation myocardial infarction is associated with myocardial salvage and area at risk assessed by cardiovascular magnetic resonance

“…As PET imaging is limited by the requirement to perform the study hyperacutely, at the actual time of reciprocal change, these findings were limited to just nine patients, all of whom had inferior territory infarction. Gibelin et al 20 also studied inferior infarction using biplane X-ray ventriculography and concluded that reciprocal changes were associated with adverse left ventricular function and increased in-hospital complication rate in 83 patients. An evaluation of 44 patients using radionuclide ventriculography found similar associations 2.…”

ST Segment Elevation Right Ventricular Myocardial Infarction due to Isolated Right Ventricular Branch Occlusion During Right Coronary Artery Stenting

“…The ECG of our case showed, during PCI, no reciprocal ST segment depression in anterior derivations and ST elevation only in V1-V4 leads. In the occurrence of anterior ST segment depression during acute inferior MI, the proposed explanations vary from extensive inferoposterior infarction or additional anterior ischemia to a reciprocal change [5][6][7].…”