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- W2008045688 abstract "In 15 necropsy-proved cases with various congenital cardiac malformations, potential sources of error were present when utilizing conventional electrocardiographic criteria to determine ventricular hypertrophy. These potential sources of error were the ultimate result of three types of posteriorly oriented QRS sE loops, with the culminative electrical forces in all cases resulting in rS complexes in lead V1 and deep S complexes in lead V6. Type I QRS sE loops were oriented right and posterior. Each case at necropsy showed isolated right ventricular hypertrophy. The proper electrocardiographic interpretation of right ventricular hypertrophy is aided by a predominant R wave in lead V4R and marked right axis deviation in the frontal plane, even though an rS or QS wave is present in lead V1. Type II QRS sE loops were positioned directly posterior, with little rightward or leftward projection, producing sterotype rS complexes in all precordial leads, including lead V4R. This type of QRS loop is present in malformations with distortions of their conduction system. Type III QRS sE loops, positioned posterior, leftward, and superior, also have rS complexes in V1. By conventional electrocardiographic criteria each case had left ventricular hypertrophy, confirmed in all at necropsy. In addition, however, relatively deep S waves and tall R waves were present in V6 and aVR, respectively. These patterns might suggest additional right ventricular hypertrophy—a supposition unconfirmed at necropsy. Thus we interpret these patterns as a manifestation of marked left ventricular hypertrophy, even though the terminal portion of the QRS sE loop is rightward and posterior. The association of marked left axis deviation and a decrease in the size of the S wave in lead V7 aids in the proper diagnosis of isolated left ventricular hypertrophy." @default.
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- W2008045688 date "1965-03-01" @default.
- W2008045688 modified "2023-10-16" @default.
- W2008045688 title "The Significance of the Posteriorly Oriented QRS sE Loop in Congenital Heart Disease" @default.
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- W2008045688 doi "https://doi.org/10.1378/chest.47.3.254" @default.
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