The unipolar Leads of the electrocardiogram in right ventricular enlargement: Juan Codina-Altés, M.D., and Carlos Pijean de Beristain, M.D., Barcelona, Spain

Abstract

1.1. Seven cases are reported which show huge T-waves in the precordial leads of the electrocardiogram.2.2. In all cases the large waves disappeared at a later date.3.3. These huge T-waves are sometimes clicited from a small area of the precordium only. If the anterior electrode is placed clsewhere on the anterior chest wall, they may not appear in the tracing.4.4. The symptoms in this group of cases point to the diagnosis of coronary occlusion. Their relative mildness suggests the complete occlusion of a small vessel or the partial occlusion of a large one.5.5. The lesion associated with huge upright T-waves in precordial leads is probably located in the auterior surface of the left ventricle. The fact that this clectrocardiographic phenomenon has not been seen in a series of 550 controls, makes it seem justifiable to regard it as indicative of an acute or subacute disturbance of the coronary circulation.6.6. Large inverted T-waves in precordial leads considerably exceeding the normal amplitude probably signify the presence of a lesion in the posterior surface of the left ventricle, analogous to that causing huge upright T-waves.7.7. RS-T interval deviations may be absent in this group of cases.8.8. A small upward deflection, prior to the downward deflection of QRS in precordial leads, has been observed in several of these cases. This wave is probably an abnormal finding, if more than 2 mm. in height.