Circulation, Vol 66, 422-428, Copyright © 1982 by American Heart Association
R Warner, NE Hill, PR Sheehe, S Mookherjee, CT Fruehan and H Smulyan
New electrocardiographic (ECG) criteria for the diagnosis of inferior
myocardial infarction (IMI) are proposed. The criteria are based upon the
relationships between portions of the vectorcardiographic (VCG) QRS loop in
the frontal plane and the corresponding portions of the ECG QRS complexes
recorded in leads II and III. The application of the proposed criteria
requires that the tracings be obtained with three-channel ECG machines so
that the temporal relationships between the QRS complexes in lead II and
those in simultaneously recorded lead III can be inspected. This type of
analysis of the ECG permits important features of the contour of the VCG
QRS loop to be predicted. The proposed ECG criteria for the diagnosis of
IMI are: in the absence of counterclockwise rotation in the frontal plane,
(1) Q waves of 30 msec or longer in lead II or (2) regression of initial
inferior forces from lead III to lead II. The proposed ECG criteria were
evaluated in an initial series of 333 patients and, using a blind
experimental design, in a confirmatory series of 94 patients. The
performance of the proposed criteria was statistically superior to that of
two sets of ECG Q-wave criteria and comparable to that of the VCG criteria
of Starr et al.
ARTICLES
Improved electrocardiographic criteria for the diagnosis of inferior myocardial infarction
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