Significance of reciprocal ST segment depression in acute inferior myocardial infarction

Abstract EN

Back ground and purpose : Precordial ST segment depression can occur in patients with acute inferior myocardial infarction.

The aim of this study is to find if there are differences between patients without reciprocal changes, patients with reciprocal changes maximum in V1-V3 and patients with reciprocal changes maximum in V4-V6 regarding the results of echocardiography, angiography and development of complications and in hospital mortality.

Patient and method : From April 2009 to April 2010, 72 patients with acute inferior myocardial infarction were included in this study divided into three groups, group I with no ST depression, Group II maximum ST depression in V1-V3 and group III with maximum ST depression in V4-V6.

Echocardiography was done, patients were followed for development of complications and mortality and coronary angiography was done to 16 patients.

Results : Remote regional wall motion abnormality was highest in group III 90 % compared with group II 72 % and group I 15 %.

Ejection fraction was lowest in group III 36 ± 10 % compared with group II 42 ± 10 % and group I 56 ± 11 %.

Complications and mortality were as follows : group III (60 % complication and 20 % mortality), group II (32 % complication and 8 % mortality) and group I (7 % complications and 2 % mortality).

Coronary angiography showed multivessel disease in group III (71%) , group II 50% and group I 33 %.

Conclusion : Precordial ST depression specially V4-V6 reflects larger infarction size or multivessel disease thus carries worse prognosis with lower ejection fraction, more regional wall motion abnormalities and higher complications and mortality.