Left Axis Deviation in Inferior Infarction; Vectorcardiographic Recognition of Concomitant Left Anterior Hemiblock

Kulbertus, H; Collignon, P; Humblet, L; Deleval-Rutten, F.

doi:10.1378/chest.60.4.362

Cited by 24 publications

(4 citation statements)

References 8 publications

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“…If this is the case, the VCG provides the typical pattern of inferior infarction in the presence of LAH. [17][18][19] The most characteristic finding of this association is found in the frontal plane of the VCG, where the initial 25-millisecond vector, instead of being oriented inferiorly and to the right, is inscribed to the right, usually with clockwise rotation. The remaining QRS loop rotates counterclockwise as expected in LAH ( Figure 5).…”

Section: Inferior Wall Myocardial Infarction Concealed By Lahmentioning

confidence: 99%

Hemiblocks Revisited

2007

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Abstract-The trifascicular nature of the intraventricular conduction system and the concept of trifascicular block and hemiblock were described by Rosenbaum and his coworkers in 1968. Since then, anatomic, pathological, electrophysiological, and clinical studies have confirmed the original description and scarce advances have been developed on the subject. In the present study, we attempt to review and redefine reliable criteria for the electrocardiographic and vectorcardiographic diagnosis of left anterior and posterior hemiblock. One of the most important problems related to hemiblocks is that they may simulate or conceal the electrocardiographic signs of myocardial infarction or myocardial ischemia and may mask or simulate ventricular hypertrophy. Illustrative examples of these associations are shown to help the interpretation of electrocardiograms. The incidence and prevalence of the hemiblocks is presented based on studies performed in hospital patients and general populations. One of the most common causes of hemiblocks is coronary artery disease, and there is a particularly frequent association between anteroseptal myocardial infarction and left anterior hemiblock. The second most important cause is arterial hypertension, followed by cardiomyopathies and Lev and Lenègre diseases. The hemiblocks may also occur in aortic heart disease and congenital cardiopathies. Left anterior hemiblock is more common in men and increases in frequency with advancing age. Evidence is presented regarding the relationship of spontaneous closure of ventricular septal defects, which may explain the finding of this and other conduction defects in young populations. Isolated left anterior hemiblock is a relatively frequent finding in subjects devoid of evidence of structural heart disease. Conversely, isolated left posterior hemiblock is a very rare finding; its prognostic significance is unknown and is commonly associated with right bundle-branch block. The most remarkable feature of this association is that the prognosis is much more serious with a great propensity to develop complete atrioventricular block and Adams-Stoke seizures. Key Words: epidemiology Ⅲ heart septal defects Ⅲ myocardial infarction Ⅲ heart block Ⅲ bundle-branch block T hirty-eight years have elapsed since Rosenbaum et al published their seminal work that put together diverse previous observations and brought about a rational and complete analytic approach to the trifascicular concept of intraventricular conduction.These conclusive studies and an exhaustive review of the preceding knowledge of the subject were first published in the Spanish monograph, 1 and later a shorter updated version was presented to acquaint the English reader with the electrocardiographic manifestations and clinical correlation of the abnormal spread of ventricular excitation. 2 A series of articles published by the same authors between 1969 and 1973 also contributed to the expansion of the recognition of this research work. As stated by Herman N. Uhley, 3 this work triggered and infl...

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Section: Inferior Wall Myocardial Infarction Concealed By Lahmentioning

confidence: 99%

Hemiblocks Revisited

2007

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“…For example, the typical QR or QS morphology in an inferior myocardial infarction in the inferior limb leads may be masked by an established LAHB if the infarction spares areas of early left ventricular activation. In addition, the positive T waves seen inferiorly in LAHB may conceal the electrocardiographic signs of an inferior myocardial infarction—accordingly, a negative T wave in II, III and aVF in the presence of LAHB is an indicator of coexistent inferior myocardial ischaemia 4 – 6. The presence of LAHB in a ‘stocky’ patient with a horizontal heart may also conceal an anterior myocardial infarction 3.…”

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Inferior quality of care and outcomes for acute coronary syndrome with left anterior hemiblock

Gale

2014

Heart

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“…συνύπαρξις κατωτέρου εμφράγματος και ΑΠΗΑ57 ,58 , ενώ αναφέρεται όλιγώτερον συχνά και ή συνύπαρξις προσθίου εμφράγματος (ιδία προσθ/γίου και προσθ/κοΰ) μέ ΑΠΗΑ12 ,13 ,31 . Τό τελευταΐον τούτο καταφαίνεται είς τήν Ι κατηγορίαν της παρούσης εργασίας, όπου τα άτομα ΦΕ-ΤΑ και ΧΣ παρουσιάζουν ΑΝΚ/κώς εικόνα προσθιοδιαφραγματικοΰ εμφράγματος μέ ΑΠΗΑ.…”

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“…Τήν IV αυτήν κατηγορίαν προσπαθήσαμεν να άναλύσωμεν θεωρητικώς και παρετηρήσαμεν δτι, είς τό κατώτερον έμφρα γμα ή παρουσία μιας ήλεκτρικώς αδρανούς ζώνης, είς τό διαφραγματικόν τμήμα τής καρδιάς έχει ώς αποτέλεσμα τήν ρήξιν τής ισορροπίας των η λεκτρικών δυνάμεων πού φυσιολογικώς γεννώνται κατά τήν διάρκειαν τής κοιλιακής έκπολώσεως. Ό όρος «άνυσμα τοΰ εμφράγματος» (Infarction Vector)19 ,58 έχρησιμοποιήθη δια νά αντιπροσώπευση τήν δύναμιν έκείνην. ή οποία είναι ϊση εις μέγεθος άλλα αντίθετος εις κατεύθυνσιν μέ εκεί-Tò έμφραγμα δηλαδή χορηγεί δυνάμεις (ανύσματα) κατευθυνομένας προς τα άνω άνευ ανταγωνισμού υπό έτερων, ώς γίνεται φυσιολογικώς.…”

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Συμβολη Του Ανυσματοκαρδιογραφηματος Εις Την Αναλυσιν Του Αριστερου Αξονος

Τριανταφυλλου¹

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Ή εγκρισις διδακτορικής διατριβής υπο της Ιατρικής Σχολής τοϋ Εθνι κού και Καποδιστριακοϋ Πανεπιστημίου 'Αθηνών δεν ύποδηλοΐ άποδοχήν των γνωμών τοϋ συγγραφέως. ('Οργανισμός του Πανεπιστημίου 'Αθη νών, άρθρον 202, § 2, Νόμου 5343).

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Left Axis Deviation in Inferior Infarction; Vectorcardiographic Recognition of Concomitant Left Anterior Hemiblock

Cited by 24 publications

References 8 publications

Hemiblocks Revisited

Hemiblocks Revisited

Inferior quality of care and outcomes for acute coronary syndrome with left anterior hemiblock

Συμβολη Του Ανυσματοκαρδιογραφηματος Εις Την Αναλυσιν Του Αριστερου Αξονος

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