Electrocardiographic changes after acute coronary occlusion

Schwentker, Francis F., and Noel, William W.: The Circulatory theria. Bull. Johns Hopkins Hosp. 45: 276, 1929.

Failure

of Diph-

In an analysis of 1600 consecutive cases of diphtheria admitted to the Sydenham Of these, 139 followed laryngeal Hospital from 1920 to 1927, there were 178 deaths. diphtheria while the remaining 39 were definite clinical cases of circulatory failure. According to the clinical course and the findings at autopsy, thr authors believe that the evidence allows a classification of circulatory failure of diphtheria into two groups, early and late. This classification is bnsrd uot on the time of onset of failure but on the appearance of the patient. The cases of early circulatory failure are an essential part of the diphtheria intoxication aud are the end-stage of thr disease, the result of a virulent infection and too often of neglect on the part of the parents to summon a physician until the c,ondition has become alarming. Vasomotor collapse with toxemia forms the outstanding picturr. Cases of late circulatory failure occurred as early a4 the eighth day of the disease but usually ten to twenty days after the onset. The usual course was that after :I week or more of apparent convalescence, the patient suddenly complained of sympt,oms referable to the heart. There were disturbances of cardiac rhythm with evidence of congestive failure; death was often rcrp sudden. Thus late circulatory failure is a complication of the disease caused probably by local inflammatory reactions illcidrnt to regeneration and repair in the cardiac tissue.

Oettinger, Ztschr.

Jacob: f. klin.

Electrocardiographic med.

110:

57A,

Changes After

Acute Coronary

Occlusion.

1!)29.

In two cases of acute coronary thrombosis, one of which was confirmed hy autopsy, the author found the following electrocardiographic rhnnges: 1. In one case, during the first few days following the occlusion, there was au a.bnormal elevation of the R-T interval above the basn line, the T-wave rising directly from the upper half of the descending limb of the R-wave and merging into the uext P-wave. On the sixth day after the occlusiau, Lead I showed :I sh:trl’ inversion of the T-wave. 2. In the second case, low amplitude similar changes in the R-T interval.

of the

rentricaular

c~oml~lex

was

found

with

A note is made of a case of mitral stenosis in which au antemortem diagnosis of coronary embolism, established by electrocardiographic studies, was confirmed b) autopsy. This case will be reported elsewhere. Due credit is giveu to American workers for their early recognition of coronary thrombosis as a clinical entity. Jones,

H.

Indicator

Wallace,

and

Roberts,

R. E.:

of Changes in Ventricular

The Electrical Predominance.

Axis of the Heart Quart.

J.

Med.

as an 23:

67.

1929. The authors have studied the effect of ventricular preponderance on the form In order to give a mathematical of the electrocardiogram in several groups of cases. value to different degrees of preponderance, the calculation of the electrical axis of the heart has been determined hy the formula and graphic method proposed by Ca,rter, Richter and Greene. The first group of cases studied showed the effect of respiration and posture on the electrical axis of normal hearts. The group showed that these two factors usually produced profound changes in the position of thr heart and form of the electrocardiogram. In cases where there is a fixed apex beat clinically, due t,o adherent pericardium, the movements of the electrical axis with respiration show by contrast with the