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Lal K, Singh N, Kumar A, et al. Association of ischemic electrocardiographic changes in high-altitude areas with coronary angiography. Med J Armed Forces India. 2021;77(4):403-407doi: 10.1016/j.mjafi.2020.11.001.
Lal, K., Singh, N., Kumar, A., Agarwal, N., Datta, R., Datta, R., Bhardwaj, P., Chadha, D. S., Ghosh, A. K., & Kumar, R. (2021). Association of ischemic electrocardiographic changes in high-altitude areas with coronary angiography. Medical journal, Armed Forces India, 77(4), 403-407. https://doi.org/10.1016/j.mjafi.2020.11.001
Lal, Krishan, et al. "Association of ischemic electrocardiographic changes in high-altitude areas with coronary angiography." Medical journal, Armed Forces India vol. 77,4 (2021): 403-407. doi: https://doi.org/10.1016/j.mjafi.2020.11.001
Lal K, Singh N, Kumar A, Agarwal N, Datta R, Datta R, Bhardwaj P, Chadha DS, Ghosh AK, Kumar R. Association of ischemic electrocardiographic changes in high-altitude areas with coronary angiography. Med J Armed Forces India. 2021 Oct;77(4):403-407. doi: 10.1016/j.mjafi.2020.11.001. Epub 2021 Aug 20. PMID: 34594067; PMCID: PMC8459035.
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Med J Armed Forces India. 2021 Oct;77(4):403-407. doi: 10.1016/j.mjafi.2020.11.001. Epub 2021 Aug 20.

Association of ischemic electrocardiographic changes in high-altitude areas with coronary angiography.

Medical journal, Armed Forces India

Krishan Lal, Navreet Singh, Anil Kumar, Naveen Agarwal, Rajat Datta, Rashmi Datta, Prashant Bhardwaj, D S Chadha, A K Ghosh, Ratheesh Kumar

Affiliations

  1. SMO, HCMS, LNJP Civil Hospital, Kurukshetra, Haryana, India.
  2. Senior Adviser (Cardiology), AFCME Subroto Park, New Delhi, India.
  3. Senior Adviser (Medicine and Cardiologist), 7 Air Force Hospital, Kanpur, U.P., India.
  4. Dy Commandant & Chief Instructor, Army Medical Centre, Centre & College, Lucknow, India.
  5. IHQ, MoD (Navy), New Delhi, India.
  6. MG (Med), Delhi Area, New Delhi, India.
  7. Addl DGMS Army, Office of DGMS Army, IHQ MoD, New Delhi, India.
  8. Professor and Senior Consultant (Cardiology), Manipal Hospitals, Kodihalli, Bangalore, India.
  9. Senior Adviser (Medicine and Cardiology), Army Institute of Cardio Thoracic Sciences, Pune, 40, India.
  10. Senior Adviser (Medicine and Cardiology), Command Hospital (Eastern Command), Kolkata, India.

PMID: 34594067 PMCID: PMC8459035 DOI: 10.1016/j.mjafi.2020.11.001

Abstract

BACKGROUND: Soldiers native to lowlands, while sojourning at high altitude (HA), are referred to tertiary care centers with electrocardiographic (ECG) abnormalities. Exposure to HA may precipitate myocardial ischemia in subjects with underlying coronary artery disease (CAD). Conversely, it may produce physiological ECG changes mimicking those of CAD, causing a diagnostic dilemma. This study sought to correlate the presence of CAD on coronary angiography (CAG) with a putative diagnosis of CAD based on clinical findings and ECG.

METHODS: A prospective study was conducted on patient's from HA areas, referred for evaluation for CAD to a single center at near-sea-level. Thirty-five minimally symptomatic/asymptomatic soldiers with ECG changes suggestive of CAD, underwent CAG. Correlation was sought between ECG and CAG evidence of CAD.

RESULTS: The association of CAD on CAG with clinical and ECG diagnosis of CAD was not significant, 4 of the 35 soldiers (11.4%) showing CAG evidence of CAD (chi square 3.849, p = 0.697). The association between symptoms and coronary artery lesions was, also, not significant, only four of twenty-three (17.4%) minimally symptomatic subjects having CAD on CAG.

CONCLUSION: Insignificant numbers of previously healthy persons, who present with minimal symptoms and ECG changes suggestive of CAD while sojourning at HA, have coronary artery involvement on CAG. Those with incidental ECG changes, without symptomatology, do not have CAD on CAG.

© 2021 Director General, Armed Forces Medical Services. Published by Elsevier, a division of RELX India Pvt. Ltd.

Keywords: Coronary angiography; Coronary artery disease; Electrocardiography; High altitude

Conflict of interest statement

The authors have none to declare.

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