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Article
August 11, 1917

ELECTROCARDIOGRAPHIC CHANGES ASSOCIATED WITH MYOCARDIAL INVOLVEMENTWITH SPECIAL REFERENCE TO PROGNOSIS

JAMA. 1917;LXIX(6):429-431. doi:10.1001/jama.1917.02590330013004
Abstract

Theoretical considerations have led us to investigate a certain type of electrocardiogram with a view to determining its relationship to myocardial involvement. We were struck by the fact that the electrocardiograms interpreted as due to bundle branch lesions in human beings differed considerably from those resulting from experimental bundle branch lesions in animals. Moreover, pathologically the occurrence of a lesion confined to either of the main bundle branches is a rarity. In fact there is scarcely a single absolutely convincing reported case, confirmed by pathologic examination, of bundle branch block. On the contrary, pathologic examination in cases diagnosed electrocardiographically as bundle branch block has for the most part failed to show definite bundle branch lesions.

However, it is common pathologic experience to find lesions in the lower third of the septum involving the wall of the left ventricle and, as will be shown, such lesions are the usual findings in

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