Electrocardiographic changes during transesophageal echocardiography in patients with coronary artery disease

ABSTRACT

This study aimed at assessment of the stressful effect of TEE on patients with coronary artery disease. The study included 2 groups of patients. Group I consisted of 25 patients with documented CAD, and group II consisted of 5 normal volunteers. Coronary artery disease was documented in addition to the history, by one or more of the following positive investigations Exercise stress test, dipyridamole stress test or coronary angiogram, while group II underwent only treadmill exercise test before TEE. Heart rate, blood pressure and ECG were recorded before and during TEE examination. No patient had ischemic changes in the ECG at rest prior to TEE. The sensitivity and specificity for ST segment depression during TEE, in relation to coronary angiogram were 54.5% and 100%, respectively. No patient suffered from chest pain during TEE except for sinus tachycardia, no significant arrhythmias occurred. Thus silent ischemia was only observed in 48% of all patients of group I. The high incidence of ST changes was observed more in patients with more than one vessel disease in comparison with those with single vessel disease