Inferior myocardial infarction

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The correlation of the electrocardiogram with meticulous postmortem arteriographic and pathologic studies in inferior myocardial infarction was a major contribution of Myers et al.1 The purpose of this paper is to correlate the results of arteriographic and ventriculographic studies with the electrocardiogram in the same disorder.

The electrocardiograms of 2,000 consecutive patients who had cardiac catheterizations were studied using magnified 70 mm transparencies. Those tracings with peculiarities of the QRS configuration in lead AVF were selected. The original electrocardiograms, recorded on high-fidelity photographic machines (Sanborn Twin Beam) at a speed of 25 mm/sec, were then classified according to a preconceived scheme (Table 1), without knowledge of the catheterization findings. The width of the Q wave was measured from its onset to the point at which the R wave crossed the baseline. The data obtained by cardiac catheterization, including selective coronary arteriography and ventriculography, were then studied and correlated with the various abnormalities of AVF. Of the 340 patients chosen for review, selective coronary arteriograms had been done in 337 and left ventriculograms had been done in 309.

The coronary arteriograms were performed by the technique previously reported,2 and the degree of obstruction in the various arteries was estimated. The ventriculographic findings are shown in Table 2. The abnormal ventriculograms are classified according to the distribution of defective contractility: inferior, generalized, or apical.


The ventriculographic findings in 309 patients with abnormalities in AVF are shown in Table 2. Only in Group H (QRS complex with a Q > 0.03 sec) . . .



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