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March 16, 1940

Electrocardiographic Patterns: Their Diagnostic and Clinical Significance

JAMA. 1940;114(11):1010-1011. doi:10.1001/jama.1940.02810110076031

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This monograph is an outgrowth of an exhibit which the author made and found to be extremely popular. It is a thoughtful coordination of the author's own extensive studies correlated with those appearing in the literature and, while one may not agree with all the deductions arrived at, the book definitely represents a mature consideration and will be a valuable addition to the library of every one who has to deal with electrocardiograms. As the author points out in his introduction, "the proportion of the average text on electrocardiography devoted to the arrhythmias would lead one to believe that this was still the field of its major importance. More recently, the use of the electrocardiograph to detect evidences of myocardial disease has been of major interest and importance to clinicians, and it has been possible to correlate such evidence of myocardial disease with prognosis in large groups of cases, although it is difficult to apply this knowledge to the individual patient in a group."

It is becoming increasingly apparent, primarily as the result of the efforts of American students of this subject, that the primary utility of the electrocardiogram in clinical practice rests on a study of its configuration. In this monograph the greatest stress is properly given to the appearance of the electrocardiogram in coronary disease and in myocardial infarction, but the more recently developed and growing subject of the electrocardiographic appearance in other diseases is also considered. The author discusses strains on the left and on the right side of the heart, pericarditis, infections, metabolic disorders and drugs. The last chapter is devoted to the newly developed subject of precordial leads and includes a number of summary tables of the measurements in 100 normal cases of the deflections in all the chest leads recommended recently by the Committee of the American Heart Association on the Standardization of Precordial Leads. These tables should be extremely useful to the reader in setting up the limits of normality for those chest leads which are not commonly employed.

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