[Stress-ECG after myocardial infarct. Does myocardial infarct reduce the significance of stress ECG in the diagnosis of severe stenosis of the anterior interventricular ramus, the diagonal ramus and the marginal ramus of the coronary artery]. / Belastungs-EKH nach Hinterwand-Infarkt Schränkt ein abgelaufener Herzhinterwand-Infarkt den Aussagewert des Belastungs-EKG bei der Diagnose höhergradiger Stenosen des R. interventricularis anterior, R. diagonalis und R. marginalis der linken Koronararterie ein?

41 patients with inferior myocardial infarction underwent both exercise stress testing and coronary arteriography. Coronary arteriography of 15 patients showed high-degree stenosis as well as occlusions of the right coronary artery and/or of the R. circumflexus of the left coronary artery alone. In 14 of these 15 cases exercise stress testing showed a normal result, in one case results were abnormal. However, we detected additional high-degree stenosis of R. interventricularis anterior and/or of R. diagonalis and/or of R. marginalis in the other 26 patients. In 22 of these 26 cases exercise stress testing showed an abnormal result, in 4 cases it was normal. Because of a sensitivy of 84,6% and a specificity of 93,3% we can assume, that abnormal results of exercise stress testing suggest additional high-degree stenosis of the RIVA-vessel system in patient after inferior myocardial infarction. Considering an eventual bypass operation it is possible to narrow the indication for coronary arteriography.