Value of lead V4R in exercise testing to predict proximal XXXX of the right coronary artery.

@entity1 @entity17750 @entity951 @entity1188 @entity583 @entity850 @entity943
To assess the value of lead V4R during exercise testing for predicting proximal @entity850 of the right coronary artery, 107 @entity1 were studied. In all @entity1 , a Bruce exercise test with the simultaneous recording of leads I, II, @entity17750 , V1, V4 and V6 was followed by coronary angiography. Apart from registering ST segment changes in the conventional leads, all @entity1 were classified according to absence or presence of an ST segment deviation of 1 mm or greater in lead V4R. Seventy-nine of the 107 @entity1 were studied because of inadequate control of @entity951 . Seven @entity1 had had @entity583 before 40 years of age. Twenty-one @entity1 were analyzed because of severe @entity943 . In the 46 @entity1 who had a previous @entity583 , the @entity1188 location was inferior in 28 and anterior in 18. Seven of the 14 @entity1 without @entity583 and significant proximal @entity850 in the right coronary artery showed an ST segment deviation of 1 mm or greater in lead V4R during exercise. This was also observed in 11 of 18 @entity1 with an old inferior wall @entity1188 and proximal occlusion of the right coronary artery. None of the 53 @entity1 without significant proximal @entity850 in the right coronary artery showed exercise-related ST segment changes in lead V4R. Exercise-related ST segment deviation in lead V4R had a sensitivity of 56%, a specificity of 96% and a predictive accuracy of 84% in recognizing proximal @entity850 in the right coronary artery. These observations indicate that the recording of lead V4R is of value for predicting or excluding proximal @entity850 in the right coronary artery.
