Value Of Exercise Electrocardiography In Localization Of Coronary Artery Disease Lesions

In our study, patients were selected from cardiovascular outpatient clinic of Zagazig University Hospital during the period from January 1999 to February 2000.The study includes 54 patients (50 male and 4 female) with positive exercise ECG in form of ST segment depression horizontal or downs loping >1 mm.All patients underwent thorough history taking, clinical examination, resting ECG, plain chest and heart x-ray.All patients were undergoing coronary angiography and according to its result patients divided into three main groupsGroup I : Single vessel disease.Group II : Multivessel disease (two or three vessel affection). Group III : Normal coronary angiography.The aim of our work is to detect the value of exercise ECG in localization of coronary artery lesion and so results of coronary angiography in different exercise ECG lead groups are compared to results of coronary angiography to detect the senstivity, specificity, predictive value of each groupof exercise ECG lead to detect coronary artery lesions.We found that in single vessel disease (group I) lateral chest lead V3- V6 can be used to localized LAD lesions and inferior limb leads II, III, a VF can be used to localize RCA lesions where we did not find sensitive leads for LCX lesions in single vessels diseasegroup.As regard group II we found that no significant difference between senstivity, specificity, predictive value of all exercise ECG lead groups for LAD, LCX, ReA and we conclude that in multivessel disease exercise ECG can’t be used to localize the coronary artery lesions.Conclusion:As shown by analysis of our study cases, ST segment depression has a value as a localizing marker of coronary artery disease lesion in cases with single vessel lesions for left anterior descending (LAD) and right coronary artery (ReA).In cases of multivessel disease lesions (two or three vessel disease) the ST segment depression do not have this value but multiple lead group affection is suggestive of coronary multivessel lesions.