Precordial T-wave polarity changes in acute inferior infarction: A poor indicator of associated disease of the left anterior descending coronary artery

T-wave polarity in V₁ to V₃ was examined in 70 patients with acute inferior wall myocardial infarctions (IWMI) as an indicator of significant disease in the left anterior descending coronary artery (LAD). Fifty-three percent (37/70) had precordial T-wave inversions, and of these 38 percent (14/37) had angiographically significant LAD disease. Conversely, 47 percent (33/70) had upright T waves in V₁ to V₃, and of these, 52 percent (17/33) had significant LAD disease. Likewise, 41 percent of the patients with ST segment depression in V₁ to V₃ had significant LAD disease, while 50 percent of those with isoelectric ST segments were similarly affected. Finally, only 39 percent of those patients with both precordial ST segment depression and T-wave inversion had significant LAD disease. We conclude that neither anterior ST depression, T-wave inversion, nor a combination of both is a sensitive or specific indicator of LAD disease in patients with acute IWMI.