The accuracy of exercise induced ST segment elevation as a sign of left ventricular aneurysm.

In 3,108 consecutive treadmill exercise tests, ST segment elevation developed or increased over its value at rest in 47 patients (1.5%) in the area of a previous myocardial infarction. Left ventricular angiograms were performed in all cases. A left ventricular aneurysm was found in 39 of the 47 patients (83%), akinesis in four patients (8.5%), and hypokinesis in two patients (4.25%). In two of the 47 patients (4.25%), the diagnosis of hypertrophic cardiomyopathy was made. The ST segment elevation, which is produced or accentuated by exercise, is a sensitive indicator of left ventricular aneurysm and is rarely seen except in cases of abnormal contractility of the left ventricle.