Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.

先天性心疾患のベクトル心電図(Frank法)による研究 第1編 心室中隔欠損症のベクトル心電図:主として,血行動態との関連性について

森脇 重光 岡山大学医学部第一内科教室
Thumnail 87_295.pdf 899 KB
The vectorcardiograms and data from cardiac catheteriztion of 64 patients with VSD were analyzed and the following results were obtained. (1) The vectorcardiographic patterns of combined ventricular hypertrophy are found in 40% of the patients with mild cases. (2) QRS loops with delayed terminal conduction are found dominantly in severe cases; in 40% of VSD with pulmonary hypertension and in 75% of Eisenmemger Complex. (3) In 5 cases (7.8%), frontal QRS loops have counterclockwise rotation, and they direct superiorly and to the left. Four cases of them belong to severe group. (4) The vectorcardiograms of the second type in Kirklin's classification showed the overloading of right ventricle more sensitively than the first type. i.e. Ⅰ) Of 16 cases with the terminal conduction delay, only one case is the first type, 13 cases are the second type and 2 cases belong to the second plus third type. Ⅱ) In mild cases, 18 out of 20 patients with the rightward deflection of the posterior portion belong to the second type and only 2 cases belong to the first type. (5) The elevation of right ventricular systolic pressure results in an increase of the magnitudes of both maximum upward and rightward deflections of the terminal portion. (6)Large shunts from left to right result in an exceeding increase of the magnitude of spatial maximum QRS, T vectors, the maximum rightward deflection of the initial portion and the maximum leftward deflection. (7) The magnitudes of the maximum anterior deflection and the maximum inferior deflection increase correlatively with both hypertrophy and dilatation of the right ventricle.