S-T segment elevation during exercise: Electrocardiographic and arteriographic correlation in 38 patients

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

“…Furthermore, no unified hypotheses explain the mechanisms that underlie EISTE in Q wave leads. This ECG phenomenon has been attributed by various researchers to (a) wall motion abnormality [9, 10, 11, 16, 17, 18, 19, 20, 21], (b) myocardial ischemia [9, 10, 11, 12, 22, 23, 24], (c) both (a) and (b) [25, 26, 27, 28, 29], or (d) neither (a) nor (b) [30, 31, 32]. The failure of these explanations to encompass the full scope of the electrocardiographic and electrophysiologic mechanisms that underlie EISTE in Q wave leads inspired our critical review of this ECG phenomenon.…”

Clinical Characteristics of Patients With Exercise-Induced ST-Segment Elevation Without Prior Myocardial Infarction

“…[1][2][3] The mechanisms have been suggested to result from left ventricular aneurysm, left ventricular wall motion abnormalities, coronary artery stenoses and, less commonly, from coronary vasospasm. [4][5][6][7][8][9][10][11][12][13] It is important to identify the underlying factors causing the exerciseinduced ST segment elevation as the appropriate choice of treatment varies accordingly. Data is limited on the characteristics of Taiwanese patients without prior myocardial infarction who develop exercise-induced ST-segment elevation.…”

“…[1][2][3][4][5][6][7][8][9] Contrary to previous studies of patients with myocardial infarction, our data suggest that in those patients without infarction, ST-segment elevation during exercise is a marker for transient and severe ischemia. Waters et al studied 11 patients without previous myocardial infarction who had a large, reversible, exercise-induced perfusion defect on 201 Tl scintigraphy in a vascular territory corresponding to the electrocardiographic leads with ST-segment elevation.…”

Coronary Angiographic Significance of Hyperacute St-T Changes Associated with Regadenoson Stress

“…Exercise-induced ST segment elevation may also occur in the absence of ischemia in areas of previous myocardial infarction (with diagnostic Q waves and accompanying wall motion abnormalities) (2-4). In contrast to stress-induced ST segment depression, which tends to occur in the inferolateral electrocardiographic leads regardless of the site of coronary artery obstruction, exercise-induced ST segment elevation is usually localized to the area of ischemia (5,6). Vasodilator stress-induced ST segment elevation appears to be especially rare; review of the medical literature produced only two cases using dipyridamole (2, 7), three cases using adenosine (8)(9)(10), and one recently reported case using regadenoson (11).…”