Abstract:
:Numerous criteria for the diagnosis of inferior wall myocardial infarction by electrocardiogram (ECG) and vectorcardiogram (VCG) have been published, but they have not been subjected to a systematic, independent evaluation. Accordingly, we studied 146 patients undergoing cardiac catheterization; 63 were normal and 83 had a history of infarction, a significant right coronary lesion and an inferior wall motion abnormality (inferior infarction group). No ECG or VCG criteria were considered in the designation of the two groups; rather, three sets of ECG and VCG criteria were evaluated for this purpose. Specificity was excellent (98-100%) and sensitivity was poor (4-34%) by all three sets of ECG criteria, but the 1949 ECG criteria of Meyers et al. are the least sensitive (4%, p less than 0.001). Specificity (90-100%) and sensitivity (82-84%) were very good by all three VCG criteria. The VCG criteria of Starr et al. gave no false-positive results in our normal group. Because of enhanced sensitivity, the overall accuracy of the VCG was higher than that of the ECG for the diagnosis of inferior infarction (90% vs 62%, p less than 0.001). We conclude that more recent ECG criteria for the diagnosis of inferior wall myocardial infarction are highly specific, but insensitive compared with VCG criteria.
journal_name
Circulationjournal_title
Circulationauthors
Hurd HP 2nd,Starling MR,Crawford MH,Dlabal PW,O'Rourke RAdoi
10.1161/01.cir.63.5.1025subject
Has Abstractpub_date
1981-05-01 00:00:00pages
1025-9issue
5eissn
0009-7322issn
1524-4539journal_volume
63pub_type
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