In 94 patients with prominent left axis deviation, there was a marked disparity in the mean angles determined by the maximum magnitude of the deflections and that determined by areas. There was also considerable variation in the angle of the maximum vector in the frontal plane (frontal plane angle) and the angle of 50 msec vector in the frontal plane. Similar results were observed in 17 cases of ostium primum atrial septal defect. These differences contrasted with the findings in a normal group of 50 subjects where a close correlation was found. The initial vector was directed to the right in approximately 80% of normals and 60% of the patients with LAD indicative of conduction defects in the left anterior fascicular or its distal ramifications. We conclude that a rightward orientation of the 5--10 msec vector (i.e. causing a Q wave in lead 1) should not be required for diagnosis of left anterior fascicular block. The spatial orientation of the initial vector was always anterior in the control subjects. In these 'normals', as well as in the patients with left axis deviation, the initial vector varied markedly in its azimuth direction (right or left) when superiorly directed; but when inferiorly directed in the normal subjects it was virtually always directed rightward. From these data we were unable to construct rigid criteria which would reliably distinguish aberrant excitation patterns manifested by gross left axis deviation in the electrocardiograms of patients with established heart disease from subjects without defined heart disease. Old infarction patterns, anterior, inferior, and lateral were not obscured by the associated anterior fascicular block.

Adolescent↗

PubMed1978

Harvey's legacy.

Explore the source record for details and available documents.

Blood Circulation↗

PubMed1978

Thoughts on medical specialism and medical care: dilemmas and paradoxes.

Explore the source record for details and available documents.

Curriculum↗

PubMed1977

Electrocution: an ever-present hazard.

Hospitals have become safer from electric shock accidents, but physicians who delegate to the electronics experts full responsibility in this regard will be shirking an obligation. Every physician should be involved both in programs to prevent these accidents in medical settings and in efforts to educate the public concerning the risk of electrocution in and around the home.

Accidents, Home↗