Why the study?
Do minor electrocardiographic changes in patients with cardiac pain indicate a similar mortality risk as gross electrocardiographic changes?
Do minor electrocardiographic changes in patients with cardiac pain indicate a similar mortality risk as gross electrocardiographic changes?
Minor electrocardiographic changes in patients with chest pain are highly significant as they confirm a cardiac source and carry a mortality risk equivalent to gross ECG abnormalities.
Minor ECG changes signal equivalent mortality to gross abnormalities; leaves open whether this refines modern risk models without prospective data.
The recognition of the lesser changes in the electrocardiogram that indicate a limited injury of the myocardium from coronary arterial disease has reduced significantly the number of patients with cardiac pain erstwhile regarded as showing a normal tracing. Such changes include depression of any part of the S-T segment, low or blunt T waves, terminal dipping of the T wave, inversion of the U wave, notching of the descending limb of the QRS in lead CR7, and the appearance of a Q wave in IIIR when it has been absent in lead III (Evans and McRae, 1952; Evans, 1951). Although such deformities in the cardiogram are small ones, they loom large in their significance, because in the first place they confirm a cardiac source for pain in the chest, and secondly because the mortality rate among patients showing them is the same as in those with gross changes like deeply inverted T waves with or without abnormal Q waves.
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Evans et al. (1957) studied this question.
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