Serial changes in voltage, QRS vectors, and QRS-T angles were studied in 44 patients who had shown improvement in their electrocardiograms during treatment for hypertension. Changes were observed in a number of electrocardiographic voltage criteria often used in the study of left ventricular hypertrophy. This is consistent with a change in the magnitude of the mean QRS vector and its reflection on a variety of ECG leads even if pretreatment records were normal. Improvement also occurred in the mean T vectors and the QRS-T angle. It is proposed that serial changes in the ECG might be of greater value than pretreatment abnormalities in diagnosing the disorder of cardiac structure or function that occurs in hypertension.
SUMMARYOver an 11-year period, 28 instances of acute myocardial infarction and bilateral bundle-branch block were encountered. Twenty-two of these patients had right bundlebranch block and left axis deviation, and six had right bundle-branch block and block of the inferior radiation of the left bundle. The overall incidence of complete heart block in these 28 cases was 21%. In-hospital mortality for the whole group was 36%, whereas it was 33% for those patients who developed complete heart block. From
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