Diagnostic significance of an exercise-induced prominent U wave in acute myocardial infarction

In conclusion, a prominent U wave induced by exercise testing in patients with anterior wall AMI is a highly specific but insensitive marker for the narrowing of the left circumflex or right coronary artery, due to confounding effects of repolarization abnormalities upon U-wave analysis, although a U-wave increase alone with or without ST-segment depression may help better identify these coronary artery narrowings. In patients with inferior and/or posterior AMI, a prominent U wave is regarded as a simple electrocardiographic marker for inferior and/or posterior residual ischemia.