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韓國人 心電圖에 關한 硏究 (第Ⅱ篇) (第二回 軍陣醫學協會總會宿題報告)

THE ELECT1OCARDIOCItAPHIC STUDY ON KOREANS (Ⅱ)

항공의학 1955년 3권 6호 p.1 ~ 13
서순규,
소속 상세정보
서순규 (  ) - 항공의학연구소

Abstract


The heart position and electrocarocardiogram
The electrocardiographic changes occurring with alterations of posture, artificial pneumoperitoneum and pneumothorax were used to study the effect of the heart position on electrocardiogram. Comparative studies of electrocardiogram and teleoroentgenogram were also done.
A series of 12 routine leads of electrocardiogram were examined in supine position, left lateral and right lateral position, sitting position and standing position on 20 cases of apparently normal males.
The effect of artificial pneumoperitoneum on ECG was studied on. 8 cases of patients with mild pulmonary tuberculosis and the effect of artificial pneumothorax on 3 cases similar cases.
The patterns of RS- T segments of various normal forms changed a among themSelves quite frequently I, III AVL, and V1, less frequently in Lead II and AVF by postual chnges, pneumoperitoneum and pneumothorax. A slight elevation of the RST segment occurred in various leads. There were a few cases in which previously slightly elevated RST segment became depressed but not below base line. Six cases of upright P wave in AVL -were changed into flat, diphasic or inverted P waves on. left lateral position, eight cases on right lateral 1position and one case of upright- P wave in AVL was .changed into diphasic P wave on sitting position.
On left lateral position, 2 cases (55 a) converted to right axis deviation and 2 cases to left axis deviation. On right lateral position, 2 cases of previous. lt axis deviation were converted to normal axis and the remaining cases were not changed. On standing position, 5 cases converted to right axis deviation and 2 cases of previous left axis deviation converted to normal axis. On sitting position 3 cases converted to left axis deviation and remaining cases , were not changed.
The changes of the amplitude of R wave due postual change were measured in all cases. The amplitudes of R wave was changed according to axis deviation. But even , in cases without remarkable , change of electricarl axis, there were. slight changes of R wave amplitude showing some grades of axis deviation to, either direction.
Nine cases (45?) of upright T wave in Lead III were inverted in sitting position, 4 cases (20? ) yin 6tanding position, and 2 cases (10?) in left lateral position Two cases of upright T waves in Lead III were changed into diphasic 1 wave in left lateral position and one case in. sitting position.. The direction of T wave in AVL, AVF and V1 was also changed into diphasic or inverted T wave but less frequently than in III. The changes of amplitude of T waves were measured in all cases and varied according to, the changes of electrical axis. The electrocardiographic heart positions changed with the axis deviation but the occurrence was less frequent than the changes of R amplitude or electrical axis: This may be due to many cases of previous vertical heart position. By artificial pneumoperitoneum 2 cases of left axis deviation were converted to normal axis and by artificial pneumothorax, one case declined to right axis deviation.
Telegroentgenogram and ECG were examined on 34 cases of apparently healthy males. There was no correlation between anatomical axis of the heart, transverse diameter of heart.and electrical axis, electrocardiographic heart position.
These results showed that the heart position influences the normal electrocardiographic findings such as the form and shifting of RST segment, driection of T wave in Lead III end in other leads, direction of P wave especially inAVL and the electrical axis.
The mechanism and frequency of electrocardiographic changes due to the change of heart position were discussed and it was concluded that the frequency of changes of ECG due to position of the heart in this study was less than those of the Nat honson and Louis´s reports.

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