Old tools for sophisticated diagnosis: Electrocardiography for the assessment of myocardial viability

The identification of residual myocardial viability in patients with a previous myocardial infarction has important clinical implications. Various methods have been developed for the detection of viable myocardium, however most of them are expensive and available only to high-tech centers. In the attempt to obtain reliable information at a low cost, exercise-ECG has been proposed as a useful technique. The results of a series of studies show that ST segment elevation and ventricular arrhythmias elicited by exercise are reliable signs of the presence of reversible myocardial damage.