Objective: In this study, importance and utilization of electrocardiography (ECG) in identifying the location of lesions and its comparison to coronary angiography (CA) were investigated in cases with ischemic localizations determined by ECG. Sensitivity, specificity and positive predictability values, total obstructions in vessels and incidence of multiple vessel disease were also sought.

Materials & Methods: A total of 101 cases (78 men, 23 women) ageing between 28 and 74 (52.1±10.9) were divided into three groups according to ECG findings. Group-I (38) included cases who had myocardial infarction in ECG, Group-II (38) having T negative and Group-III (25) with normal resting ECGs. Localizations, according to derivation in ECG were classified as I, aVL, V1-6 anterior, and II, III, aVF inferior. CA was applied after ECG recordings, >50% narrowing in the coronary artery lumen was considered to be important.

Results: Narrowing in the artery responsible for lesion in the fact group-I or Group-II which had anterior or inferior localizations in ECG (LAD for anterior wall, RCA or CX for inferior wall) the sensitivity values (according to presence or absence of narrowing in CA) were found to be 71%, 63% and 56%, specificity 51%, 78%, 73% and positive predictability 50%, 58%, 43%, respectively. Comparison of narrowing in CA in Group-I showing inferior or anterior localizations showed that the total obstruction values were 60% and 18%, respectively, (P<0.01) and the incidence of multiple vessel disease 67% and 24%, respectively (P<0.05). Of the cases with T negativity (Group-II) and normal ECG (Group-III), 58% and 36% had significant coronary narrowing, respectively.

Conclusion: Our findings have shown that ECG is a useful method in predicting the coronary artery responsible for myocardial ischemic lesions, and it is more sensitive in the diagnosis of cases with GMI pattern.