CORONARY ARTERY DISEASE AND T WAVE INVERSIONS IN ELECTROCARDIOGRAM AT HIGH ALTITUDE

Coronary Artery Disease and T Wave Inversion

Abstract

Objective: To find out the role of coronary artery disease (CAD) as a cause of T wave inversions in electrocardiogram (ECG) in otherwise healthy soldiers who were evacuated from high altitude because of chest pain. 
Study Design: A prospective observational study 
Place and duration of study: The study was carried out at CMH Skardu from September 2003 to September 2004 
Patients and Methods: fifty-four consecutive patients evacuated from height > 4000 meters (13123 feet) with symptoms of chest pain and electrocardiographic changes of T-wave inversions in a group of leads were included in the study. Echocardiography and Exercise tolerance test (ETT) was performed on all the patients. All of the patients with indeterminate or inconclusive results on ETT underwent coronary angiography at Armed Forces Institute of Cardiology, Rawalpindi . 
Results: Out of 54 patients, 36 (66.7%) patients had normal exercise tolerance test. In the rest 18 (33.34%) patients coronary angiogram was done and in 04 patients it was reported abnormal. In 02 (3.70%) patients coronary angiogram confirmed coronary artery disease. In 02 patients coronary angiograms were abnormal but there was no evidence of coronary artery disease. 
Conclusion: T wave inversions at high altitude suggestive of IHD are not true indicators of underlying coronary artery disease.