The diagnosis of infarction of the interventricular septum

Osher, Harold L.; Wolff, Louis

doi:10.1016/0002-8703(53)90153-7

Cited by 28 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reversible nature of CHB observed in 19 of 24 patients and the similarity of mortality rates for all patients and those with CHB (35% and 38%, respectively) suggest that agonal physiological derangements were not a factor in the conduction disturbances reported. Previous investigators'9-23 have described CHB in anterior as well as posterior myocardial infarction, with higher mortality rates occurring in patients with anterior infarction20 and with BBB.20 24 It has also been reported that in posterior infarction incomplete A-V block is common-and BBB is rare, whereas in anterior infarction BBB is common and incomplete A-V block is rare.23 25 The chief form of A-V block observed in anterior infarction is CHB.23 25 The results of Previous studies have also associated various BBB patterns with septal infarction18 26 and have correlated BBB with CHB in septa] infarction.20 23 25,27 30 Some of these studies23 29,30 have included patients with CHB and RBBBQV,, the form of BBB that was observed in association with CHB in this series. The recognition and classification of BBB is of necessity partly arbitrary.…”

Section: Discussionmentioning

confidence: 99%

Observations on Heart Block During Continuous Electrocardiographic Monitoring in Myocardial Infarction

Stock

Macken

1968

Circulation

View full text Add to dashboard Cite

Complete heart block (CHB) was observed in 24 of 350 patients with myocardial infarction who were studied under conditions of continuous electrocardiographic monitoring. CHB occurred predominantly in posterior and anteroseptal infarctions. In posterior infarction CHB was observed in patients who also developed first degree (10) and types I and II second degree (2°-I and 2°-II) atrioventricular (A-V) block but not bundle-branch block (BBB). In anteroseptal infarction CHB was found in patients with BBB, occasionally in patients with 2°-II A-V block, but not in patients with 1°a nd 2°-I A-V block. Right BBB with a Q wave in lead V1 was the usual form of BBB observed in patients with CHB and anteroseptal infarction. One mechanism for sudden death in anteroseptal infarction is the abrupt development of CHB following the onset of BBB. Evidence is presented attributing CHB to a lesion in the A-V node in posterior infarction and to bilateral BBB in anteroseptal infarction. Additional Indexing Words: Bilateral bundle-branch blockWenckebach's phenomenon Complete heart block Type II second degree A-V block Stokes-Adams attacks IN RECENT YEARS there has been considerable interest in continuous electrocardiographic monitoring of patients with acute myocardial infarction during the early stages of their disease.1 One purpose of this surveillance has been to detect disturbances of atrioventricular (A-V) conduction that lead to complete heart block (CHB) with critical slowing of the ventricular rate or the complete absence of ventricular depolarization. As yet, none of the reports2-8 on electrocardiographic monitoring have specifically dealt with abnormalities signaling impending CHB, although Lown and associates7 have stated that in general advanced degrees of block develop slowly, allowing time for lifesaving interventions such as electrical pacing.9-12Our interest arose from the observation that some patients developed CHB abruptly from one atrial beat to the next without antecedent dropped ventricular beats or prior abnormality of the P-R interval. In this group the rapidity of the course did not allow time for the initiation of pacing once CHB occurred. Clearly, death could be avoided only if it were possible to recognize in advance those patients prone to this arrhythmia. To this end we reviewed electrocardiograms obtained by continuous monitoring in 350 patients with a diagnosis of acute myocardial infarction (table 1). From this total, 24 patients with CHB were identified. When the data were examined, certain patterns emerged which might allow more accurate prediction of CHB. 993at University of Pennsylvania Library on June 29, 2015 http://circ.ahajournals.org/ Downloaded from

show abstract

Section: Discussionmentioning

confidence: 99%

Observations on Heart Block During Continuous Electrocardiographic Monitoring in Myocardial Infarction

Stock

Macken

1968

Circulation

View full text Add to dashboard Cite

show abstract

“…However, rupture of the septum occurs in only 1 per cent of infarct deaths (Griffith, Hegde, and Oblath, 1961). Though the electrocardiographic features of septal infarction are well recognized (Osher and Wolff, 1952), we have found only one report of electrocardiographic changes recorded at the time of septal rupture (Normand et al, 1965). We, therefore, report details of another patient in whom the electrocardiogram was recorded at the time of septal rupture.…”

mentioning

confidence: 90%

“…Significant areas of necrosis are found in the interventricular septum of 60 per cent of patients dying from acute myocardial infarction (Osher and Wolff 1952). However, rupture of the septum occurs in only 1 per cent of infarct deaths (Griffith, Hegde, and Oblath, 1961).…”

mentioning

confidence: 99%

Electrocardiographic changes produced by interventricular septal rupture.

Kerr¹,

Haywood²

1976

Heart

View full text Add to dashboard Cite

show abstract

“…Even though 70% of all myocardial infarctions may involve the septum to some extent, (Osher and Volff, 1953) the incidence of septal rupture is only in the range of 0.5 to 1% (Friedberg, 1966). The mortality is extremely high and within 24 hours of rupture about 24% of the patients are dead.…”

Section: Introductionmentioning

confidence: 99%