Abstract：Objective To investigate the value of dynamic electrocardiogram in the diagnosis of asymptomatic myocardial ischemia. Methods From November 2016 to November 2017, a total of 120 patients with asymptomatic myocardial ischemia treated in our department of cardiology were enrolled in the study. Routine electrocardiogram and dynamic electrocardiogram were performed respectively among patients. Routine electrocardiogram was used as control group and dynamic electrocardiogram was selected as observation group. The coronary angiography results were used as the gold standard to compare the diagnostic sensitivity, specificity and accuracy of the two groups. Meanwhile, these results were compared with dynamic electrocardiogram changes in 120 patients with symptomatic myocardial ischemia, and the dynamic electrocardiogram changes in patients with asymptomatic myocardial ischemia at different time points were analyzed. Results The sensitivity, specificity and accuracy of the observation group were significantly higher than those of the control group, and the difference was statistically significant (P＜0.05). The heart rate of asymptomatic myocardial ischemia was higher than that of symptomatic myocardial ischemia, the duration of ischemia was shorter than that of symptomatic myocardial ischemia, the ST segment depression was significantly lower than that of symptomatic myocardial ischemia, and the differences were statistically significant (P＜0.05). In patients with asymptomatic myocardial ischemia, the ST segment depression at 8：00-18：00 was more than that at 18：01-6：00, and the ST segment depression time was shorter than that at 18：01-6：00, variability of myocardial ischemic valve was lower than that at 18：01-6：00,and the differences were statistically significant (P＜0.05). Conclusion The diagnosis of dynamic electrocardiogram in patients with asymptomatic myocardial ischemia is remarkable, with high accuracy and sensitivity, which can effectively reflect the regularity of symptoms, providing a substantial basis for clinical diagnosis and treatment.
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