The Value of Exercise Electrocardiography and Exercise Thallium‐201 Myocardial Perfusion Scanning in Determining the Presence of Single Vessel Coronary Artery Obstruction

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Abstract
In 39 patients with single vessel coronary artery disease and no previous myocardial infarction, excercise 201Tl myocardial perfusion scanning and 12 lead exercise ECG were compared to see how reliably each method identified the site of coronary artery obstruction. Significant (.gtoreq. 70% diameter) stenosis was present in the left anterior descending (LAD) coronary artery in 21 patients, in the right coronary artery (RCA) in 14 patients and in the left circumflex (LCX) in four patients. Tl defects on the scan in the septal, anteroseptal and anterior segments correlated (P < 0.0005) with LAD disease and defects in the interior, posteroinferior, and posterior segments correlated (P < 0.0005) with RCA or LCX disease. Exercise induced ST segment elevation in VI and/or AVL correlated with LAD disease. The site of ischemic ST depression did not correlate with disease in any vessel. ST segment depression in leads L2, 3, AVF (67%) and in leads V4-6 (67%) was most sensitive for detecting patients with LAD disease and ST depression in leads V4-6 was most sensitive for detecting patients with RCA or LCX disease but neither differentiated LAD from RCA/LCX disease.