Among 23,059 patients who underwent exercise myocardial tomography between 1985 and 1994 at our institution, there were 817 (3.5%) with a strongly positive exercise electrocardiogram and normal myocardial tomograms. Among these, 52 patients had no conditions known to be associated with a false-positive exercise electrocardiogram and no previous coronary revascularization, and underwent coronary angiography. Of the 32 patients with significant coronary stenoses, 50% had 1-vessel disease and only 22% had 3-vessel disease (p <0.05). Among 55 stenosed arteries, 56% were of moderate severity (50 to 74%), whereas only 9% had subtotal or total occlusion (95 to 100%) (p <0.001). There was a significant gender difference in the prevalence of significant coronary stenoses (80% in male vs 24% in female patients, p <0.0001). A strongly positive exercise electrocardiogram coupled with normal exercise myocardial tomograms is a rare clinical finding. In women, this finding is usually associated with normal coronary arteries, whereas in men it often denotes coronary artery disease, usually of mild to moderate degree.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine