2003, Number 1
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Arch Cardiol Mex 2003; 73 (1)
On the clinical value of electrocardiogram
de Micheli A, Medrano GA, Iturralde P
Language: Spanish
References: 26
Page: 38-45
PDF size: 94.13 Kb.
ABSTRACT
Emphasis is given to the clinical value of the electrocardiogram, a simple,
quick and unexpensive method for heart exploration. It provides functional
information and reliably reflects the metabolic and electrolytic characteristics
of myocardial fibers. Such an information cannot generally be obtained by
other more sophisticated and expensive methods. The localization and extension
of myocardial infarction, the positional and structural changes observed during
the evolution of chronic cor pulmonale of obstructive origin, some
characteristics of atrial and ventricular arrhythmias, the site of
preexcitation in WPW syndrome and troubles due to a dysfunction of the ionic
channels because of metabolic or genic alterations, are particularly examined.
1. A good correlation exists between the anatomical site and
electrocardiographic indication of the infarcted area. 2. In the obstructive
chronic cor pulmonale, positional and structural changes of the heart are
observed. The first ones correspond to a vertical heart, due to a descent
of the diaphragm and an increase of lung volume. The structural changes are
due to an enlargement of the right heart: dilatation and hypertrophy. 3.
Ventricular arrhythmias habitually present the "jumping wave" phenomenon
between both septal masses and the consecutive aberrance of the ventricular
complexes. 4. In the WPW syndrome, the thoracic circle permits to infer the
site of preexcitation by the orientation of the first fronts of anomalous
ventricular activation. 5. Modifications in the Q-Tc interval reflect the
variations of ionic intracellular concentrations in a more reliable way than
the changes of plasmatic concentrations. The aforementioned evidences the
great usefulness of the electrocardiogram in the clinical setting.
REFERENCES
Sodi Pallares D, Bisteni A, Fishleder BL, Medrano GA: Importance of the unipolar morphologies in the interpretation of the electrocardiogram: the theoretical basis of the unipolar morphologies and its correlation with vectorial analysis, with cardiac activation, and with the potential variations at the epicardial surface of the heart. Am Heart J 1959; 57: 590-605.
Sodi Pallares D, Piccolo E, De Micheli A, Anselmi G, Medrano GA: Il valore clinico dell’elettrocardiogramma nell’infarto miocardico sulla base di una correlazione anatomo-elettrocardiografica. Cardiol Prat 1961; 12: 547-572.
De Micheli A, Medrano GA: El diagnóstico electrovectocardiográfico de zona inactivable miocárdica. Arch Inst Cardiol Mex 1989; 59(2): 195-210.
De Micheli A, Medrano GA: Enfoque electrofisiológico del diagnóstico de bloqueos ventriculares izquierdos no complicados y complicados. Arch Inst Cardiol Mex 1996; 66(1): 70-82.
De Micheli A, Medrano G, Sodi Pallares D: Il valore clinico dell’elettrocardiogramma nel cuore polmonare cronico. Mal Cardiovasc 1962; 3(3): 433-456.
Zuckermann R, Cabrera Cosio E, Fishleder BL, Sodi Pallares D: Electrocardiogram in chronic cor pulmonale. Am Heart J 1948; 35: 421-437.
De Micheli A, Medrano GA: La exploración electrovectocardiográfica en la cardiopatía de origen pulmonar. Arch Inst Cardiol Mex 1987; 57(2): 85-96.
Masini V, Concina B, Piani A: L’elettrocardiogramma del cuore polmonare cronico nella fase di riacutizzazione e di miglioramento clinico. Cuore Circol 1961; 45: 77-96.
Maurice P, Barrillon A, Lenegre J: Evolution des signes électriques du coeur pulmonaire chronique. Arch Mal Coeur 1960; 53: 522-535.
Sodi Pallares D: New bases of electrocardiography. St-Louis MO. Mosby Co, 1956, p. 404.
Iturralde Torres P: Taquicardias supraventriculares. En Arritmias cardíacas. II Ed. México. McGraw-Hill Interamericana, 2002, pp. 244-256.
Medrano GA, De Micheli A, Aranda A, Iturralde P: ¿Es aún válido el concepto de “salto de onda”? Arch Inst Cardiol Mex 2000; 70(1): 19-29.
Iturralde Torres P: Taquicardias ventriculares. En Arritmias cardíacas. II Ed. México. McGraw-Hill Interamericana, 2002, pp. 357-374.
Iturralde Torres P. Ibidem, p. 370.
De Micheli A, Medrano GA, Iturralde P: El círculo torácico en la exploración eléctrica del corazón. Arch Inst Cardiol Mex 2000; 70(2): 187-196.
Ueda H, Nameki C, Saruta H, Kawamura H, Yoshida A, Tsuzuku A: Further studies on the WPW syndrome (preexcitation syndrome) with special reference to the intracardiac and esophageal lead. Jpn Circ J 1957; 21: 361-375.
De Micheli A, Medrano GA: Observaciones sobre ciertos aspectos electrovectocardiográficos del síndrome de WPW. Arch Inst Cardiol Mex 1976; 46 (4): 356-380.
Iturralde P, Araya V, Colín L, Kershenovich S, De Micheli A, González Hermosillo JA: A new electrocardiographic algorithm for the localization of accessory pathways using only the polarity of the QRS complex. J Electrocardiol 1996; 29(4): 289-299.
De Micheli A, Medrano GA: ¿Qué debemos entender por isquemia, lesión y necrosis? Arch Inst Cardiol Mex 1994; 64(2): 205-221.
De Micheli A, Medrano GA, Testelli M, Sodi Pallares D: L’action de certaines substances chimiques sur l’électrogramme, l’électrocardiogramme et la courbe de tension artérielle chez le chien. Mal Cardiovasc 1963; 4: 607-649.
Mendez R, Pastelín G: Modificaciones farmacológicas de los fenómenos bioeléctricos de los tejidos y células del corazón. Gac Med Mex 1970; 100(Supl. 1): 27-40.
De Micheli A, Medrano GA, Villarreal A, Sodi Pallares D: Observaciones sobre la intoxicación quinidínica experimental. Arch Inst Cardiol Mex 1972; 42(4): 580-588.
Brugada P, Brugada J: Right bundle branch blocks, persistent ST segment elevation and sudden cardiac death; a distinct clinical and electrocardiographic syndrome. J Am Coll Cardiol 1992; 20: 1391-1396.
Towbin JA, Wang Z, Li H: Genotype and severity of long Q-T syndrome. Drug Metab Dispos 2001; 29(4) Part 2: 574-579.
De Micheli A: Del “De viribus electricitatis...” de Galvani a la moderna electrovectocardiografía. Arch Inst Cardiol Mex 1991; 61(1): 7-13.
De Micheli A, Vázquez J: El centenario de la radiología. Arch Inst Cardiol Mex 1995; 65(5): 389-394.
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