The Value of Anginal Pain in Exercise Testing After Myocardial Infarction

The result of treadmill exercise tests were studied in 158 patients (pts) who were exercised submaximally 1 to 3 month after an acute transmural myocardial infarction. A 4 minute test had initially been performed prior to their discharge, 14 to 20 days after the acute event. Eight pts had and inferior and 65 an anterior infarction; 13 could not be reliable classified and were not further included. In the inferior infarction group, 10/80 had a positive test characterized by ST changes (9 pts), and aniginal pain (4 pts.). In the anterior infarction group, 11/65 had a positive test: ST-changes could be reliable assessed in only 2, while 9 had anginal pain; one had ventridular tachycardia. Fourteen pts underwent coronary arteriography; all showed severe triple vessel disease, and in 8 myocardial revascularization was performed. In pts with a previous anterior myocardial infarction, anginal pain can be a very helpful finding, since ST changes are usually hard to interpret.