Coronary arteriograms and myocardial scintigrams in the electrocardiographic syndrome of septal fibrosis

Coronary artery disease (CAD) and myocardial perfusion were assessed by arteriograms and scintigrams (Technetium-99 microspheres alone or combined with Iodine-131 albumin macroaggregates) in 178 angina pectoris patients with and without the electrocardiographic (ECG) syndrome of septal fibrosis and with ≥70% obstruction in one or more coronary arteries. The ECGs of 96 patients without angiographic evidence of obstructive CAD were also examined for the ECG syndrome of septal fibrosis. Patients with the ECG syndrome of septal fibrosis have significantly higher incidences of positive exercise stress test, of ≥70% narrowing of the proximal left anterior descending (LAD) artery, of severe proximal LAD disease, and of more extensive left ventricular hypoperfusion than patients without the ECG syndrome. The fact that only 4% of patients without obstructive CAD have the ECG syndrome of septal fibrosis indicates the usefulness of the syndrome in identifying a subset of angina pectoris patients with advanced CAD of the proximal LAD and diffuse left ventricular hypoperfusion.