A Clinical Appraisal of the Vectorcardiogram in Myocardial Infarction

IT HAS BEEN ARGUED that the vectorcardiogram should yield no more information than a standard 12-lead electrocardiogram. Yet many authors, including Wolff," 2 Burch,3-5 Scherlis and Grishman6 and Milnor,7 employing different lead systems, have published data indicating that the vectorcardiogram may demonstrate abnormalities not apparent in the electrocardiogram. Of a total of 2,545 vectorcardiograms recorded over a 2-year period in patients hospitalized at the Peter Bent Brigham Hospital 368 fulfilled the criteria, to be described below, for the diagnosis of myocardial infarction. Sixty-seven of these patients were subsequently examined post mortem. The 368 recordings fell into two groups, one in which the Grishman cube8 (161 cases) was employed, the other in which the corrected lead system of Frank9 (207 cases) was used. This communication will deal exclusively with the results obtained by the former technic. Based upon the results of a correlation between anatomic and vectorcardiographic findings, a division into distinct groups of vectorcardiographic patterns was established and these were expressed in numerical values. In addition an evaluation was made of the accuracy of the vectorcardiogram recorded by the cube