Key result
Right-sided valvular stenosis links to rightward axis deviation, while hypertension and AR link leftward.
Why the study?
Mitral stenosis, pulmonic stenosis, aortic regurgitation, and hypertension often affect the electrocardiogram by causing abnormal swings of the heart's electrical axis, but detailed characterization was needed.
Observational (n=1,000)
No
May inform ECG interpretation in valvular disease; leaves open rigorous testing against contemporary standards.
Just seven years ago Dr. Arlie V. Bock and I1presented before the American Society of Clinical Investigation a report entitled: "Electrocardiographic Evidence of Abnormal Ventricular Preponderance and of Auricular Hypertrophy." That report was based on the electrocardiograms of about 1,000 cases studied in the course of two and one-half years at the Massachusetts General Hospital. Our conclusions were that mitral stenosis and pulmonic stenosis do often affect the electrocardiogram to produce an abnormal swing of the electrical axis of the heart to the right, and that hypertension and aortic regurgitation often cause an abnormal swing of the axis to the left. We used the formula which Lewis2had suggested in 1914, simply the sum in tenths of a millivolt of the amplitudes of R in Lead I plus S in Lead III minus the sum of S in Lead I plus R in Lead III; that is (Ri +
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PAUL DUDLEY WHITE (1924) conducted an observational in Mitral stenosis, pulmonic stenosis, aortic regurgitation, and hypertension (n=1,000). Mitral stenosis, pulmonic stenosis, aortic regurgitation, and hypertension was evaluated on Abnormal swing of the electrical axis of the heart. Mitral and pulmonic stenosis often produce an abnormal rightward swing of the electrical axis, while hypertension and aortic regurgitation often cause an abnormal leftward swing.
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