{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T18:58:53Z","timestamp":1766516333720,"version":"3.46.0"},"reference-count":15,"publisher":"BMJ","issue":"6393","license":[{"start":{"date-parts":[[1983,9,3]],"date-time":"1983-09-03T00:00:00Z","timestamp":431395200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1983,9,3]]},"abstract":"<jats:p>In acute myocardial infarction depression of the ST segment in leads distant from those showing ST elevation has been considered to be \"reciprocal\" but might reflect local ischaemia. To examine this possibility 103 consecutive patients who underwent exercise testing early after myocardial infarction were reviewed. Treadmill exercise testing was performed a mean of 12 (range 5-30) days after infarction using a limited Naughton protocol. Thirty five (34%) of the patients had had reciprocal change, defined as greater than or equal to 1 mm ST depression in leads remote from the site of the infarct, within 48 hours of infarction. Twenty two (63%) of the 35 patients developed exercise induced ST depression in the leads previously showing reciprocal change. Coronary artery disease was assessed in 10 of these patients by arteriography and in four at necropsy: all but one had stenosis of greater than or equal to 50% in a coronary artery supplying the reciprocal territory in addition to the disease in the vessel to the infarct site. Of patients with reciprocal ST depression, 23.5% experienced nonfatal reinfarction, pulmonary oedema after discharge, or death compared with only 9.5% of patients without reciprocal ST depression. Eight (23.5%) patients with reciprocal depression had ventricular fibrillation while in hospital compared with only two (3%) patients without. Reciprocal ST depression in acute myocardial infarction may reflect ischaemia in territory distant from the site of infarction and is associated with a high risk of fatal arrhythmias and late morbidity.<\/jats:p>","DOI":"10.1136\/bmj.287.6393.634","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"634-637","source":"Crossref","is-referenced-by-count":31,"title":["\"Reciprocal\" depression of the ST segment in acute myocardial infarction."],"prefix":"10.1136","volume":"287","author":[{"given":"K","family":"Jennings","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D S","family":"Reid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D G","family":"Julian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1983,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/0002-8703(49)90564-5","article-title":"Correlations of electrocardiographic and pathologic findings in anteroposterior infarction","volume":"37","author":"Myers, G.B.; Klein, H.A.; Hiratzka, T.","year":"1949","unstructured":"Myers GB, Klein HA, Hiratzka T. Correlations of electrocardiographic and pathologic findings in anteroposterior infarction. Am Heart J 1949;37:205-36.","journal-title":"Am Heart J"},{"key":"ref_2","first-page":"232","article-title":"Myocardial infarction","author":"Marriott, H.J.L.","year":"1977","unstructured":"Marriott HJL. Myocardial infarction. In: Marriott HJL, ed. Practical electrocardiography. Baltimore: Williams and Wilkins, 1977:232-55."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/0002-9149(80)90345-8","article-title":"Non-invasive identification of a high risk subset of patients with acute inferior myocardial infarction","volume":"46","author":"Shah, T.K.; Pichler, M.; Berman, D.S.","year":"1980","unstructured":"Shah TK, Pichler M, Berman DS, et al. Non-invasive identification of a high risk subset of patients with acute inferior myocardial infarction. AmJ Cardiol 1980;46:915-21.","journal-title":"AmJ Cardiol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/0002-9149(81)90312-X","article-title":"Significance of reciprocal ST segment depression in anterior precordial leads in acute inferior myocardial infarction: concomitant left anterior descending disease?","volume":"48","author":"Salcedo, JR, Baird; MG, Chambers; RJ, Beanlands; D.S.","year":"1981","unstructured":"Salcedo JR, Baird MG, Chambers RJ, Beanlands DS. Significance of reciprocal ST segment depression in anterior precordial leads in acute inferior myocardial infarction: concomitant left anterior descending disease? 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Amy Cardiol 1981;48:1009-15.","journal-title":"Amy Cardiol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/S0002-9149(77)80207-5","article-title":"Chronic stable inferior myocardial infarction: unsuspected harbinger of high-risk proximal left coronary arterial obstruction amenable to surgical revascularisation","volume":"39","author":"Miller, R.R.; DeMaria, A.N.; Vismara, L.A.","year":"1977","unstructured":"Miller RR, DeMaria AN, Vismara LA, et al. Chronic stable inferior myocardial infarction: unsuspected harbinger of high-risk proximal left coronary arterial obstruction amenable to surgical revascularisation. AmJ Cardiol 1977;39:954-60.","journal-title":"AmJ Cardiol"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1161\/01.CIR.62.3.509","article-title":"Ischemia at a distance after acute myocardial infarction: a cause of early post-infarction angina","volume":"62","author":"Schuster, E.H.; Bulkley, B.H.","year":"1980","unstructured":"Schuster EH, Bulkley BH. Ischemia at a distance after acute myocardial infarction: a cause of early post-infarction angina. Circulation 1980;62: 509-15.","journal-title":"Circulation"},{"key":"ref_8","first-page":"451","article-title":"Multivessel coronary artery spasm","volume":"6","author":"Dunn, R.F.; Kelly, D.T.; Sadick, N.; Uren, R.","year":"1979","unstructured":"Dunn RF, Kelly DT, Sadick N, Uren R. Multivessel coronary artery spasm. Circulation 1979;6O:451-5.","journal-title":"Circulation"},{"article-title":"The provocation of coronary arterial spasm in patients with recent transmural myocardial infarction. Eur Heart3'","author":"Bertrand, M.E.; Lablanche, J.M.; Tilmant, P.Y.; Thieuleux, F.A.; Deforge, M.G.; Chahine, R.A.","key":"ref_9","unstructured":"Bertrand ME, Lablanche JM, Tilmant PY, Thieuleux FA, Deforge MG, Chahine RA. The provocation of coronary arterial spasm in patients with recent transmural myocardial infarction. Eur Heart3' (in press)."},{"issue":"58","key":"ref_10","article-title":"Electrocardiographic changes in single-vessel disease","volume":"1978","author":"Griffith, L.C.; Grundwald, L.; Achuff, S.C.","unstructured":"Griffith LC, Grundwald L, Achuff SC. Electrocardiographic changes in single-vessel disease [Abstract]. Circulation 1978;58 suppl 2:238.","journal-title":"Circulation"},{"key":"ref_11","first-page":"276","article-title":"Angina pectoris. III. Demonstration of a chemical origin of ST depression in classical angina pectoris, its variant form, early myocardial infarction and some non-cardiac conditions","volume":"3","author":"Prinzmetal, M.; Ekmekci, A.; Toyoshima, H.; Kwoczynski, J.K.","year":"1959","unstructured":"Prinzmetal M, Ekmekci A, Toyoshima H, Kwoczynski JK. Angina pectoris. III. Demonstration of a chemical origin of ST depression in classical angina pectoris, its variant form, early myocardial infarction and some non-cardiac conditions. Am J7 Cardiol 1959;3:276-93.","journal-title":"Am J7 Cardiol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1161\/01.CIR.66.4.732","article-title":"Precordial ST segment depression during acute inferior myocardial infarction: clinical, scintigraphic and angiographic correlations","volume":"66","author":"Gibson, R.G.; Crampton, R.S.; Watson, D.D.","year":"1982","unstructured":"Gibson RG, Crampton RS, Watson DD, et al. Precordial ST segment depression during acute inferior myocardial infarction: clinical, scintigraphic and angiographic correlations. Circulation 1982;66:732-41.","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1136\/hrt.48.6.560","article-title":"Precordial ST segment depression in patients with inferior myocardial infarction: clinical implications","volume":"48","author":"Gelman, J.S.; Saltups, A.","year":"1982","unstructured":"Gelman JS, Saltups A. Precordial ST segment depression in patients with inferior myocardial infarction: clinical implications. Br Heart J 1982; 48:560-5.","journal-title":"Br Heart J"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/0002-9149(82)90306-X","article-title":"ST segment depression in patients with acute inferior myocardial infarction","volume":"50","year":"1982","unstructured":"ST segment depression in patients with acute inferior myocardial infarction. 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