Detection of the ischemic reaction of the myocardium by means of the polar coordinates of the ST segment in the corrected orthogonal ECG
Reinhold, D.; Göhler, K.
Zeitschrift für die Gesamte Innere Medizin und ihre Grenzgebiete 34(16): 441-446
1979
ISSN/ISBN: 0044-2542 PMID: 395778 Document Number: 150069
In the case of coronary heart disease the behaviour of the ST segment proved to be of major diagnostic importance for the recognition of hypoxidotic processes in the myocardium. Isolated consideration of the T-wave does not provide any characteristic information. The so-called ischaemic reaction is characterized by a typical jump of polar vectors from the left to the right side, which are moved rearwards without usually leaving the right-hand quadrant at the front. The angles of elevation are in a horizontal position or directed slightly upwards. This change of the direction can but need not include an increased magnitude. It is possible to observe the development of ischaemia as exercise is increased, with the polar vectors increasing or unchanging in magnitude and being moved rightwards, rearwards, and upwards. This characteristic movement invariably starts at the J point, involving additional portions of the ST segment as ischaemia is developed during increasing exercise. The J point depression should be considered to be only a "normal" response to exercise, provided the variations relate to the J point or 20 ms away from the latter.