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

THE ELECT1OCARDIOCItAPHIC STUDY ON KOREANS (IV)

항공의학 1955년 3권 6호 p.37 ~ 50
서순규,
소속 상세정보
서순규 (  ) - 공군 항공의학연구소

Abstract


Abnormal electrocardiogram
Among abnormal electrocardiograms studies, were ventricular hypertrophy, the criteria for diagnosis in Koreans, heart block and 170 random ECGs. The accuracy of criteria for dianosis of left and right ventricular hypertrophy were studied on 20 cases of left ventricular hypertrophy due to hypertensive cardiovascular disease and aortic insufficiency with stenosis and 15 cases of right ventricular hypertrophy due to mitral stenosis. Subjects were diagnosed by history, physical and roentgenological examination. In cases of left ventricular hypertrophy, the pattern of left ventricular strain with diphasic or inverted T wave were observed in 80% of cases in V5V6 and AVL in 70% of cases in Lead I and II with depressed junction J ranging 0.5 and 2.0 mm. There were one case of LVS, LVS with LAD, LVH without strain and normal ECG. Sixteen cases were the case of LVH with strain. There were 9 cases (45?) of counterclockwise rotation and 5cases of horizontal or semihorizontal, heart position.
In cases of RVH, the pattern of ventricular strain with diphasic or inverted T. wave was obseved in 66.6%of cases in AVF, 5.3.3% of cases in Lead III and V1, 46.6a of cases in. V2 20? a of cases, in V1. There were 2 cases of right ventricular strain& 8 cases of RVH strain. Nine Cases (60%) of RAD, 12 cases of vertical heart position and cases of clockwise rotation were observed. In cases of LVH, Gubner´s criteria
R1+ S3>25mm was positive in 6 cases(30y?).Sokolow´s criteria, Ravl>llmm in 6 cases (30%), Rvs or
V6<26mm,in 8 cases (40%), LVAT 0.05sec. in 5 cases 25?) Sv1Rv5>35MM, in 17 cases (85?), Sv1+Rv5>43mm. in 16 cases 00Y ) were positive. No case of R in AVF was higher than 20mm. Wilson´s criteria,- QS pattern of V1´:and V2-were positive in 8 ´cases´(40%), presence of Q wave in V5, in 6 cases (30 a) wave in Vs, in-5 gages (25 ), -Prolonged QRS -duration, "ranging 0.10 to-.0.lisec. in s cases´ (25°0).
In cases of RVH, Sokolow criteria, Rvl ?mm was posit ve u_5 -uses (33 Kve>5mm, in 2. cases (13.3 a,), Sv1>2mm, in 6 cases (40% Rv1+Sv5 X10 mm. in 8 cases (53.3 ? ), RVAT 0.04 sec in 7 cases (46.6% ). Myer´s critereria, F>3mm, was positive in only one case. Prolonged P wave ranging 0.10 to 0,6 sec. with notching were observed in 12 cases (800).
These results, showed that each criteria is positive only in less than 40% of cases except Sokolow´s criteria Svl, +Rvs>35mm and no one criteria is enough for the diagnosis of ventricular hypertrophy. Sokolow´s criteria Svl, +Rvs>35mm should be also changed to Sv1+Rvs>43mm to apply to Korean ECG especially to male adult referring Korean normal, range of the value of Svl, +Rvs.
ECGs of 170 cases of patient studied showed that high frequency of rheumatic valvular disease, hypertensive heart and heart neurosis with several kinds of arryhthmia. Also it was emphasized that there were few cases of myocardial infarction, congenital anormaly, chronic cor pulmonale and electrolyte imbalance.
The last grade A-V block were observed in 4 cases of soldier and 3 cases of children who were apparently healthy. The cause of this block were discussed and rheumatic affection and vagal tonus were considered as causes. Six cases of RBBB were observed in two healthy soldiers, in 2 cases of neurosis, and in one case of. pulmonary tuberculosis and aortic aneurysm. Each patient was studied for about one year. There Was no, development of heart disease nor exaggeration. The patters of- RBBB were not changed and persistent. Also there were no change of RBBB pattern by the test of occulocardiac reflex,carotid sinus reflex exercise and postural change in 4 cases studied.

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