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Resting electrocardiogram in major coronary artery disease.

Seventeen of 106 patients with triple-vessel coronary artery disease had completely normal electrocardiograms. Of those patients with abnormal ECGs (89 of 106, 84%), a total of 75 had QRS disturbances, with Q waves of myocardial infarction accounting for 64 of 75 (85%). Patients with 100% obstruction of one or more coronary arteries (56 of 106, 53%) had abnormal QRS due to Q waves of myocardial infarction in 40 of 56 (71%). Three patients with 100% obstruction had normal ECGs. It is concluded that a substantial number of patients with significant triple-vessel coronary artery disease will have normal resting ECGs, and the resting ECG does not reliably predict the extent of coronary artery disease.