Thirty-two patients presenting with acute transmural inferior wall myocardial infarction underwent cardiac catheterization and angiography within 12 hours of onset of symptoms. Twelve lead electrocardiograms performed within 11/2 hours of catheterization revealed the following: Seventeen patients exhibited ST-segment depression in the anterior precordial leads in addition to inferior wall changes (group A). Fifteen patients did not manifest any ST-segment changes in the anterior precordial leads (group B). Clinical, arteriographic, and ventriculographic variables were compared between the two groups. No significant differences were observed with regard to age, sex, risk factors for coronary disease, duration of symptoms prior to angiography, Killip class, number of inferior leads with ST-segment elevation, or initial creatine kinase. The extent of coronary artery disease as well as the prevalence of severe disease in the left anterior descending artery were similar for both groups. Biplane left ventriculography revealed no significant differences between the two groups with regard to global or local left ventricular function.

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