급성하벽심근경색 환자에서 흉부유도 ST 절하강의 임상적 의의

The prognostic significance of precordial ST segment depression during early stages of acute inferior myocardial infarction is controversial. To examine this problem, electrocardiographic findings on admission were compared with the clinical variables in 50 patients with a first transmural inferior infarction. Patients were classified according to the admission ECG obtained an average of 7.0hours after the onset of chest pain. Twenty-five patients (group I) had≥1.0mm ST depression in at least one of leads V1 to V6 and 25 (group II) did not. There were no significant differences between the two groups in peak creatinine kinase activity, prevalence of in-hospital complications (i, e., congestive heart failure, hypotension, arrhythmias requiring treatment and death), and maximal ST elevation in inferior lead. A weak correlation existed between the quantities (mV) of inferior ST segment elevation and precordial ST depression (r=0.43, p<0.05). Thus, precordial ST depression during acute inferior infarction is not a reliable marker of the extent of myocardial damage or an adverse hospital course. Precordial ST segment depression might represent a benign electrical phenomenon.