Characteristic electrocardiographic pattern indicating a critical stenosis high in left anterior descending coronary artery in patients admitted because of impending myocardial infarction

Am Heart J. 1982 Apr;103(4 Pt 2):730-6. doi: 10.1016/0002-8703(82)90480-x.


In patients admitted to the hospital because of unstable angina, a subgroup can be recognized that is at high risk for the development of an extensive anterior wall myocardial infarction. These patients, who show characteristic ST-T segment changes in the precordial leads on or shortly after admission, have a critical stenosis high in the left anterior descending coronary artery. Of 145 patients consecutively admitted because of unstable angina, 26 (18%) showing this ECG pattern, suggesting that this finding is not rare. In spite of symptom control by nitroglycerin and beta blockade, 12 of 16 patients (75%) who were not operated on developed a usually extensive anterior wall infarction within a few weeks after admission. In view of these observations, urgent coronary angiography and, when possible, coronary revascularization should be done in patients with unstable angina who show this ECG pattern.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic alpha-Antagonists / therapeutic use
  • Adult
  • Aged
  • Angina Pectoris / diagnosis*
  • Angina Pectoris / therapy
  • Constriction, Pathologic / diagnosis
  • Coronary Angiography
  • Coronary Artery Bypass
  • Coronary Vessels / pathology
  • Electrocardiography*
  • Female
  • Heart / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / prevention & control*
  • Nitroglycerin / therapeutic use
  • Prognosis
  • Risk


  • Adrenergic alpha-Antagonists
  • Nitroglycerin