[Esophageal precordial cardiac stimulation in the diagnosis of ischemic heart disease].

The esophageal atrial cardiac stimulation was applied to 93 patients divided into 4 groups: patients with typical, probable and atypical angina pectoris and clinically healthy controls. The tests positive for ischemic heart disease are classified into 3 classes according to the duration of ECG ischemic changes: I class--the ischemic changes are registered during the time of the test only; II class--the changes are seen in the first ECS complexes after the stimulation and III class--the changes persist after the second minute following the esophageal atrial stimulation. The test was worked out to diagnostic criteria in 92.5% of the cases and is undoubtedly positive in 77.5% of the patients with typical and probable stenocardia and in 36.6% of the patients with atypical precordial pain. Most important for the diagnosis of ischemic heart disease are: the early occurrence of ST-depression before the submaximal pulse rate is reached, registration of II and III degree of ST-depression and the appearance of chest pain during the time of the test. The esophageal atrial stimulation is a valuable method for the diagnosis of ischemic heart disease and it is surprisingly easy to perform. The method is harmless and can be applied to patients to whom the physical exercise test cannot be applied.