Study note
MedicineCardiology

Positive exercise ECG with severe coronary artery disease

THE CONTEXT
An illustrated exercise test demonstrates marked ECG changes despite a nearly normal resting ECG.

Resting and exercise findings

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The resting 12-lead ECG shows minor T-wave changes in the inferolateral leads but is otherwise normal.
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After 3 minutes of treadmill exercise, marked planar ST depression develops in leads V4 and V5.
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Subsequent coronary angiography reveals critical three-vessel coronary artery disease.
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