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(Circulation. 1968;37:890.)
© 1968 American Heart Association, Inc.

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The Apexcardiogram in Myocardial Asynergy

FRANCIS J. LANE M.D.¹; JOHN M. CARROLL M.D.¹; HAROLD D. LEVINE M.D.¹; RICHARD GORLIN M.D.¹

¹ From the Cardiovascular Unit, Department of Medicine, Peter Bent Brigham Hospital and Harvard Medical School, Boston, Massachusetts. Dr. Gorlin is also Investigator, Howard Hughes Medical Institute.

The apexcardiogram was analyzed in 41 patients with an altered pattern of left ventricular contraction. Four types were distinguished: type I, an early sustained systolic bulge which occurred in 12 patients, all of whom had large aneurysms and large enddiastolic volumes; type II, a bulge confined to midsystole which occurred in 13 patients, 11 of whom had some form of ventricular asynergy; type III, a late or end-systolic bulge which occurred in 12 patients, seven of whom had ventricular asynergy; type IV, a prominent spike during diastolic filling which occurred in four patients who had large zones of ventricular asynergy.

Key Words: Aneurysm • Abnormal myocardial contraction • Systolic bulge

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