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False-Positive ST-T-Wave Changes Secondary to Hyperventilation and Exercise
A Cineangiographic Correlation
- WILLIAM F. JACOBS, M.D.;
- WILLIAM E. BATTLE, M.D.; and
- JAMES A. RONAN, JR., M.D., F.A.C.P.
Abstract
Eleven patients had "positive" ST-segment depression, with exercise testing and with forced hyperventilation at rest. None of the five patients who had coronary arteriograms had evidence of coronary artery disease, and the clinical impression was that the other six patients did not have coronary artery disease. Four patients had mitral valve abnormalities, shown by the left ventricular angiographic findings of mitral valve prolapse or auscultatory evidence of the systolic click-late systolic murmur syndrome. None of the 17 control patients who had positive exercise tests and positive coronary arteriograms had positive hyperventilation studies at rest. Coronary artery disease does not seem to cause the ST-segment changes in these 11 patients; their cause is still unknown.
Article and Author Information
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▸From the Georgetown University Medical Center, Georgetown University School of Medicine, Washington, D.C.
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Grant support: grant RR006012, Clinical Study Unit, National Institutes of Health; and project 39, Metropolitan Washington Regional Medical Program.
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▸Requests for reprints should be addressed to William E. Battle, M.D., Cardiology Division (Georgetown Service), District of Columbia General Hospital, Washington, DC 20002.
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- Received February 18, 1974.
- Accepted June 18, 1974.
