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The electrocardiogram in pectus excavatum.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Oliveira, J. Martins De Sambhi, Mohinder P. Zimmerman, Hyman J. |
| Copyright Year | 1958 |
| Abstract | Pectus excavatum is a deformity of the chest that consists of backward displacement of the sternum and costal cartilages giving rise to a depression in the xiphisternal area. This malformation may appear isolated or associated with other anomalies. The occurrence of pectus excavatum with congenital heart disease has been reported by several observers (Evans, 1946; and McKusick, 1955). Embarrassment of circulation amounting to heart failure has also been described (Ravitch, 1951). Even in the absence of any cardiac condition, electrocardiographic changes are to be expected, because of alterations in the position of the heart. Whether these changes occur as a consequence of cardiac rotation only or also on account of compression of the heart by the chest cage has not yet been established. However, the recent advances in electrocardiography based on vectorial concepts allow us to consider that in cases of pectus excavatum, in the absence of associated cardiac disease, the modifications in the position of the heart are the most important factors, so far as the electrocardiographic changes are concerned. Previous reports on the electrocardiogram in this malformation exist. Dressler and Roesler (1950) in 10 of their 13 cases, reported inversion and notching of the T waves in praecordial leads (from Vl to V4) as the mostremarkable findings. Althoughmost patients in their series were adults, we are not sure that these T wave changes can be considered strictly pathological, since in our experience we have noticed that many normal women retain the juvenile T wave pattern through adult life. Wachtel et al. (1956), studying 13 other cases, described the changes in QRS complex in lead VI as the most important finding in pectus excavatum: in eight of these patients, an rsr' pattern was observed. The authors stressed that the above pattern does not indicate disturbance in conduction, but is the consequence of cardiac rotation. They further emphasized the fact that the anatomical configuration of the chest in this malformation, making the correct application of the prmcordial lead electrodes difficult, does not permit an exact evaluation of the T wave changes. |
| Starting Page | 495 |
| Ending Page | 501 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://heart.bmj.com/content/heartjnl/20/4/495.full.pdf |
| PubMed reference number | 13584636v1 |
| Volume Number | 20 |
| Issue Number | 4 |
| Journal | British heart journal |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Anatomical position Anterior chest wall structure Bone structure of rib Compression Congenital Abnormality Congenital heart disease Congenital pectus excavatum Depressive disorder Electrocardiography Heart Diseases Heart failure Patients Psychologic Displacement Sternum Structure of costal cartilage electrode observers |
| Content Type | Text |
| Resource Type | Article |
