[Stress tests and coronary angiography in chronic myocardial infarct].

In patients with myocardial infarction (MI) the presence or absence of lesions in vessels other than the one which perfuses the infarcted area, has implications regarding coronary bypass surgery, long term anticoagulant therapy, work capacity and prognosis. We investigated whether involvement of a 2nd or 3rd vessels as demonstrated by coronary angiography can be predicted on the basis of angina pectoris and/or ischemic ST-segment depression during exercise. Inferior myocardial infarction (IMI, n = 146) Severe lesions (greater than or equal to 75%) of a 2nd or 3rd vessel were found in 61.7% of patients with IMI, who developed angina pectoris and ischemic ST-segment depression, in 18.6% of patients with ST-segment depression only, in 9.1% of patients with angina pectoris only and in 3.4% with neither angina pectoris nor ST-segment depression. Anteroseptal infarction (ASI, n = 116) Severe lesions (greater than or equal to 75%) of a 2nd or 3rd vessel were found in 30.2% of patients with ASI, who developed Angina pectoris and ischemic ST-segment depression; in 26.6% of patients with ST-segment depression only, in 20.0% of patients with angina pectoris only and in 3.0% of the patients with neither angina pectoris nor ST-segment depression. The clinical implications of the results are discussed.