The Electrocardiographic and Hemodynamic Findings in Pulmonary Stenosis with Intact Ventricular Septum

Abstract

From cardiac catheterization on 53 patients with pulmonary stenosis and intact ventricular septum without other hemodynamic abnormality, correlation of peak voltage in lead V1 with pulmonary valve resistance and valve area (whose values are determined from flow and pressure values) was better than with the pressure gradient. Moderately good correlation was found between hydraulic variables and mean manifest QRS and T-wave axes in both frontal and horizontal planes. An average for each patient of QRS-T angles in the 2 planes provided best correlation with pressure gradient across valve, and good correlation with work index, valve resistance, and area. The QRS complex pattern in lead V1 showed typical right ventricular systolic-pressure overload patterns, as defined by Cabrera and Monroy, in most patients with hydraulically severe pulmonary stenosis, but, in cases of mild or moderate stenosis, the overload-pattern approach to diagnosis would be distinctly misleading.