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Ventricular repolarization in congenital aortic stenosis

Authors
Journal
American Heart Journal
0002-8703
Publisher
Elsevier
Publication Date
Volume
70
Issue
5
Identifiers
DOI: 10.1016/0002-8703(65)90389-3

Abstract

Abstract The scalar electrocardiograms in 65 cases of isolated congenital aortic stenosis in children from 11 months to 15 years of age were studied to determine criteria for assessing the severity of the stenosis. The depth of the S wave in Leads V 1 and V 2 and the height of the R wave in Leads V 5 and V 6 were not helpful, and were sometimes misleading. Measurements of disturbed ventricular repolarization (ST-T wave changes) were very useful in predicting severity in cases in which the frontal axis of QRS was +45 degrees or greater. The following features indicated severe stenosis: (1) a frontal axis of the T wave superior to +15 degrees; (2) the sum of the frontal and horizontal QRS-T angles greater than 100 degrees (the mean direction of QRS or T taken to be at right angles to the lead with a zero or equiphasic deflection in an appropriate reference frame); (3) an R T ratio in Leads V 5 or V 6 greater than 10.

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