THE DIAGNOSTIC QRS PATTERNS IN MYOCARDIAL INFARCTION
Authors: M. M. Hurwitz, R. Langendorf, L. N. Katz
Journal: Annals of Internal Medicine (1943)

Article1 December 1943THE DIAGNOSTIC QRS PATTERNS IN MYOCARDIAL INFARCTIONM. M. HURWITZ, R. LANGENDORF, L. N. KATZ, F.A.C.P.M. M. HURWITZ, R. LANGENDORF, L. N. KATZ, F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-19-6-924 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn the electrocardiographic diagnosis of recent myocardial infarction, so much emphasis has been placed on the S-T-T configuration, because of the diagnostic value of its evolution, that the importance of the QRS pattern has been insufficiently stressed. Recent experience has shown that several conditions such as acute diffuse pericarditis,1acute cor pulmonale,2acute nephritis,3toxemias of pregnancy,4hyperthyroid state in flux,5etc., may sometimes closely imitate the S-T-T pattern of myocardial infarction and less closely its evolution, without showing the specific QRS patterns expected in myocardial infarction. It therefore seemed desirable to investigate the QRS patterns encountered in recent myocardial...Bibliography1. BARNES AR (a) : Electrocardiographic patterns, 1940, John C. Thomas, Baltimore. (b) BARNES, A. R., and BURCHELL, H. B.: Acute pericarditis simulating acute coronary occlusion, Am. Heart Jr., 1942, xxiii, 247. (c) WINTERNITZ, M., and LANGENDORF, R.: Das Elektrokardiogramm der Perikarditis, Acta med. Scandinav., 1938, xciv, 141 and 274. Google Scholar2. MCGINNWHITE SPD (a) : Acute cor pulmonale resulting from pulmonary embolism, Jr. Am. Med. Assoc., 1935, civ, 1473. (b) BARNES, A. R.: Pulmonary embolism, Jr. Am. Med. Assoc., 1937, cix, 1347. (c) SOKOLOW, M., KATZ, L. N., and MUSCOVITZ, A. N.: The electrocardiogram in pulmonary embolism, Am. Heart Jr., 1940, xix, 166. CrossrefGoogle Scholar3. MASTERJAFFEDACK AMHLS (a) : The heart in acute nephritis, Arch. Int. Med., 1937, lx, 1016. (b) LANGENDORF, R., and PICK, A.: Elektrokardiogramm bei akuter Nephritis, Acta med. Scandinav., 1938, xciv, 136. CrossrefGoogle Scholar4. Unpublished observations from this laboratory. Google Scholar5. ROSEWOODMARGOLIES EFCA (a) : The heart in thyroid disease: II. The effect of thyroidectomy on the electrocardiogram, Jr. Clin. Invest., 1935, xiv, 497. (b) SPANG, K., and KORTH, C.: Das Elektrokardiogramm bei Überfunktionzustanden der Schilddrüse, Arch. f. Kreislaufforsch., 1939, iv, 189. CrossrefGoogle Scholar6. PARKINSONBEDFORD JDE (a) : Successive changes in the electrocardiogram after cardiac infarction, Heart, 1928, xiv, 195. (b) LEVINE, S. A., and BROWN, C. L.: Coronary thrombosis: its various clinical features, Medicine, 1929, viii, 245. (c) PARDEE, H. E. B.: The significance of an electrocardiogram with a large Q in Lead 3, Arch. Int. Med., 1930, xlvi, 470. (d) FENICHEL, N. M., and KUGELL, V. H.: The large Q-wave of the electrocardiogram. A correlation with pathological observations, Am. Heart Jr., 1931, vii, 235. (e) WILLIUS, F. A.: Occurrence and significance of electrocardiograms displaying large Q-waves in Lead III, Am. Heart Jr., 1931, vi, 723. (f) EDEIKEN, J., and WOLFERTH, C. C.: The incidence and significance of the deep Q-wave in Lead III of the electrocardiogram, Am. Heart Jr., 1932, vii, 695. (g) WILSON, F. N., MCLEOD, A. G., BARKER, P. S., JOHNSTON, F. D., and KLOSTERMEYER, L. L.: The electrocardiogram in myocardial infarction with particular reference to the initial deflection of the ventricular complex, Heart, 1933, xvi, 155. (h) FREUNDLICH, J.: Die klinische Bedeutung der Q-Zacke im Elektrokardiogramm, Deutsch. Arch. f. klin. Med., 1933, clxxv, 129. (i) BARNES, A. R.: Q and T types of electrocardiograms: their comparative and complementary value in indicating occurrence of acute myocardial infarction, Am. Heart Jr., 1934, ix, 722. (j) BARNES, A. R.: Correlation of initial deflections of ventricular complex with situation of acute myocardial infarction, Am. Heart Jr., 1934, ix, 728. (k) DURANT, T. M.: The initial ventricular deflection of the electrocardiogram in coronary disease, Am. Jr. Med. Sci., 1934, clxxxviii, 225. (l) WINTERNITZ, M.: The initial complex of the electrocardiogram after infarction of the human heart, Am. Heart Jr., 1934, ix, 616. (m) BARNES, A. R.: Electrocardiogram in myocardial infarction, Arch. Int. Med., 1935, lv, 457. Google Scholar7. WEINBERGKATZ HBLN (a) : A common electrocardiographic variant following acute myocardial infarction—the TN type, Am. Heart Jr., 1941, xxi, 699. (b) BARNES, A. R., and BURCHELL, H. B.: The significance of negative T-waves in all three standard leads of the electrocardiogram, Jr. Mt. Sinai Hosp., 1942, viii, 346. CrossrefGoogle Scholar8. BARNES AR (a) : Electrocardiographic pattern observed following acute coronary occlusion complicated by pericarditis, Am. Heart Jr., 1934, ix, 734. (b) LANGENDORF, R.: The influence of diffuse pericarditis on the electrocardiographic pattern of recent myocardial infarction, Am. Heart Jr., 1941, xxii, 86. CrossrefGoogle Scholar9. KATZ LN: Electrocardiography, 1941, Lea and Febiger, Philadelphia. Google Scholar10. ASHMANHULL RE (a) : Essentials of electrocardiography, 1941, Macmillan, New York. (b) SODEMAN, W. A., and ENGLEHARDT, H. T.: A QRS pattern of diagnostic value in the electrocardiogram, Am. Jr. Med. Sci., 1940, cc, 337. (c) PARDEE, H. E. B.: Clinical aspects of the electrocardiogram, 1941, Paul B. Hoeber, New York. (d) HOLZMANN, M.: Klinische Erfahrungen mit elektrokardiographischen Brustwandableitungen, Arch. f. Kreislaufforsch., 1937, i, 2. (e) JERVELL, A.: Elektrokardiographische Befunde bei Herzinfarkt, Acta med. Scandinav., 1938, Supp. 68, pp. 1 to 267. Google Scholar11. KAPLANKATZ LGLN: The characteristic electrocardiograms in left ventricular strain with and without axis deviation, Am. Jr. Med. Sci., 1941, cci, 676. CrossrefGoogle Scholar12. KATZSANDERSMEGIBOWCARLEN LNARSS (a) : Heart size and experimental atheromatosis in the rabbit, Am. Jr. Med. Sci., 1940, cc, 731. (b) PALMER, J. H.: Size of heart after coronary thrombosis, Canad. Med. Assoc. Jr., 1937, xxxvi, 387. (c) HURWITZ, M. M., and FRIEDBERG, L.: The relationship of heart size to cholesterol content in experimental atheromatosis in the rabbit, Arch. Path., 1942, xxxiv, 875. CrossrefGoogle Scholar13. SODEMANBURCH WAGE: Left axis deviation in dropped heart, Am. Heart Jr., 1938, xv, 490. CrossrefGoogle Scholar14. WILSON FN: The occurrence in angina pectoris of electrocardiographic changes similar in magnitude and in kind to those produced by myocardial infarction, Am. Heart Jr., 1941, xxii, 64. CrossrefGoogle Scholar15. ERLANGERROSENBAUMCOTRIMJOHNSTONWILSON HFFNFDFN (a) : The form of the dog's precordial electrocardiogram in bundle branch block complicated by anterior infarction, Jr. Clin. Invest., 1941, xx, 460. (b) WILSON, F. N., JOHNSTON, F. D., and BARKER, P. S.: Electrocardiograms of an unusual type in right bundle branch block, Am. Heart Jr., 1934, ix, 472. (c) BOHNING, A., and LANGENDORF, R.: Unpublished data in preparation. Google Scholar16. WINTERNITZ M: Zur Pathologie des menschlichen Vorhofelektrokardiogramms, Med. Klin., 1935, xxxi, 1575. Google Scholar17. KLAINER MJ: The prognostic significance of right axis deviation in arteriosclerotic and hypertensive heart disease, Am. Jr. Med. Sci., 1940, cxcix, 795. CrossrefGoogle Scholar18. BOHNINGKATZ ALN: Four lead electrocardiogram in cases of recent coronary occlusion, Arch. Int. Med., 1938, lxi, 241. CrossrefGoogle Scholar19. LANGENDORFPICK RA (a) : Zur Diagnose des Myokardinfarktes mit Hilfe von Brustwandableitungen, Acta med. Scandinav., 1938, xcvi, 80. (b) MORTENSEN, V.: The QRS complex in precordial leads in anterior wall infarction. True and false infarction curves, Am. Jr. Med. Sci., 1941, cci, 349. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Illinois*Received for publication September 4, 1942.From the Cardiovascular Department, Michael Reese Hospital, Chicago, Illinois.Aided by the Emil and Fanny Wedeles and the A. D. Nast Funds for Cardiovascular Research. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDer ungewöhnliche Linkstyp im ElektrokardiogrammLeft axis deviationTHE SIGNIFICANCE OF DEEP S WAVES IN LEADS II AND IIIDie Coronarerkrankungen. Coronarinsuffizienz, Angina pectoris und HerzinfarktElectrocardiogram and vectorcardiogram reconstruction and its application to clinical diagnosis of myocardial infarctionQS- and QR-Pattern in Leads V 3 and V 4 in Absence of Myocardial Infarction: Electrocardiographic and Vectorcardiographic StudyCinical Electrocardiography—Its Present Position and Possible PotentialitiesThe electrocardiographic signs of myocardial infarction in the presence of bundle branch blockMyocardial infarctionII. Correlation of electrocardiographic and pathologic findings in large anterolateral infarctsClinical analysis of the S wave pattern electrocardiogramElectrocardiograms in which the main ventricular deflections are directed downward in the standard leads 1 December 1943Volume 19, Issue 6Page: 924-951KeywordsElectrocardiographyFallsHeartInfarctionMyocardial infarctionPulmonary diseasesResearch designResearch fundingResearch laboratoriesRight ventricle ePublished: 1 December 2008 Issue Published: 1 December 1943 PDF downloadLoading ...