The precordial electrocardiogram in incomplete right bundle branch block

Barker, Joseph M.; Valencia, Fernando

doi:10.1016/0002-8703(49)90851-0

Cited by 88 publications

(9 citation statements)

References 8 publications

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“…Of the 120 tracings, 106 were of native Indians and 14 of white or mixed race born at sea level but having lived 15 In none of these cases did we find a tall R in such additional leads although the R/S ratio became gvreater than 1.0 in all the 3 eases. A tracimg of this type is presented in figure 3, with additional leads of the right side.…”

Section: M1aterial and Methodsmentioning

confidence: 77%

Electrocardiographic Patterns in Man at High Altitudes

Rotta¹,

López²

1959

Circulation

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Electrocardiograims of healthy men both native and long-term residents at 14,900 feet above sea level have been obtained and classified according to their dominant pattern. Most of the tracings showed signs of either right ventricular hypertrophy or right bundle-branch block, incomplete and complete. Some of the mechanisms responsible for these electrocardiographic changes found at high altitudes, such as pulmonary hypertension, positional changes of the heart, and chronic hypoxia, are discussed.THIE effect of chronic hypoxia due to altitude oil the right side of the heart is of particular interest. Measurements made on teleroenitgeniogramiis of the heart of normal subjects living perinianieittly-at an altitude of 14,900 feet have shown an increase in the transverse diameter of the heart and in the cardiac silhouette area, as well as a prominent )ullIlOlary-coitus. 1 Complementary fluoroscopic studies have demonstrated that an increase inl the volume of the right cavities rather than a total involvement is responsible for heart enlargememmt.4More recently, by means of cardiac catheterization, a moderate but significant increase of the pulmonary artery pressure and of total pulmonary resistance has been found in men at high altitudes.6 Finally, a variable grade of right ventricular hypertrophy has been found in a small nurnber of postmortem observations on subjects at high altitudes dying from work accidents.7TIme preceding, information, as well as preliiminary eleetrocardiographie observations carried out at this same altitude,4 at lower altitudes,5 and on1 miners without pulmonary silicosis from various altitudes and studied at sea level after several days of residence9 suggests that normal miie living at high altitudes must show some electrocardiographie signs of right ventricular hypertrophy. The work reported here was designed to shed some light on this problem. Accordingly, electrocardiograms of a group of normal subjects residing at higlh altitudes were taken and compared with normal staiidards at sea level. Electrocardiog ramiis were taken during rest in the supine position, with Sanborn Viso-Cardiette and Cambridge Simple-Trol electrocardiographs.The standard leads, 3 augmented unipolar limb leads, and 7 unipolar precordial leads from RV3 to V6 were recorded. In 18 instances RV3 was not registered; in 5 cases, the VE lead was recorded instead of RVY, and in 6 additional cases leads from right precoidiumai (RV4, RV5, and RV6) were taken. In all tracings height and duration of the P, R, S, and T waves in standard and precordial leads were tmeasured. The ventricular activation time (tinte of onset of the intrinsic deflection), from the beginning of QRS complex to the peak of R wave, was measured in V1, V5, and V6. The mean electric axis of QRS and the R/S ratio in V1, V,, and V6 were determined.

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Section: M1aterial and Methodsmentioning

confidence: 77%

Electrocardiographic Patterns in Man at High Altitudes

Rotta¹,

López²

1959

Circulation

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“…The necropsy distribution of these cases was 2 in the pulmonary heart disease group, 1 in the coronary heart disease group, 3 in the both group, and 1 in the neither group. Barker and Valencia (1949) have suggested using R in VI greater than 15 mm. to indicate right ventricular hypertrophy in the presence of right bundle-branch block, but using this with our criteria has not proved diagnostic.…”

Section: Resultsmentioning

confidence: 99%

The Recognition of Coronary Heart Disease in the Presence of Pulmonary Disease

Rees¹,

Thomas²,

Rossiter³

1964

Heart

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“…P wave abnormalities, consisting primarily of increased amplitude and notching in leads II and/or Vi are common3 , 21,22,29 and were seen in 20 (69 per cent) of our patients. First degree atrioventricular block was seen 8 times (28 per cent) and it, too, has been observed by others.6, [22][23][24][25][26][27][28]30 Atrial fibrillation was observed in 2 patients (6 per cent), both of whom had severe hemodynamic alterations.…”

Section: Patent Ductus Arte7°iosusmentioning

confidence: 87%

The Electrocardiogram in Surgically Correctable Congenital Heart Disease

1958

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The gratifying advances in the surgical therapy of congenital cardiovascular anomalies have resulted in an intensified interest in patients with these defects and increased the importance of early detection and accuracy of diagnosis. Cardiac catheterization, angiocardiography, aortography, cardiac roentgenology and the electrocardiogram are indispensable for accurate diagnosis The electrocardiogram is the most readily obtainable of these tests. It may be of considerable aid in the evaluation of patients who have or are suspected of having a congenital cardiovascular anomaly.We have reviewed the electrocardiograms of patients with proved congenital cardiovascular defects seen at the State University of Iowa Hospitals over the past 10 years in an effort to correlate electrocardiographic abnormalities with the several defects. The study has been limited to patients with the anomalies currently most amenable to surgical therapy: coarctation of the aorta, patent ductus arteriosus, ventricular septal defect, atrial septal defect, isolated pulmonic stenosis, and tetralogy of Fallot. Diagnoses were established at operation, or by autopsy, cardiac catheterization or aortography. Table 1 lists the total number of patients in each category. METHODS All electrocardiograms were recorded on a standard single channel electrocardiograph at a paper speed of 25 mm/sec. The usual standard, unipolar limb and precordial leads were obtained. In most instances additional precordial leads, V3R , V4R , Hvi , Hv2 and V7 were available for analysis. Each tracing was interpreted independently by three observers. The criteria of Dyers' as outlined in table 2 were used for the interpretation of atrial abnormality, right (RVH) and left (LVH) ventricular hypertrophy, incomplete right bundle branch block (IRBBB) with or w ithout RVH, and complete right bundle branch block (RBBB).The criteria for an rSR' type of RVH, IRBBB and IRBBB with RVH are graphically shown in figure 1. Normal variations for the P-R interval. in children were judged by the standards of Alimurung and Massell.1It is emphasized at the outset that we have applied the Dyers' criteria rigidly in the belief that an attempted correlation otherwise would TABLE 1 TABLE 2

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The precordial electrocardiogram in incomplete right bundle branch block

Cited by 88 publications

References 8 publications

Electrocardiographic Patterns in Man at High Altitudes

Electrocardiographic Patterns in Man at High Altitudes

The Recognition of Coronary Heart Disease in the Presence of Pulmonary Disease

The Electrocardiogram in Surgically Correctable Congenital Heart Disease

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