Vectorcardiographic Diagnosis

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Abstract
Since the Illus. application of vectorcardiography (vcg) to clinical cardiology is relatively new, an appraisal of its value as a diagnostic tool is desirable. The present investigation was undertaken, based on 167 unselected cases that came to autopsy. Vcg diagnoses included normal vcg, left ventricular hypertrophy (LVH), right ventricular hypertrophy (RVH), myocardial infarction (MI), and acute cor pulmonale, and were correlated with autopsy findings. Diagnostic criteria were based on previous studies in this laboratory and are clearly stated. Ecg interpretation, based on the literature, was carried out for comparison. Criteria for anatomic diagnosis are stated, and the pitfalls and inadequacies discussed. Overdiagnosis was insignificant. Superior diagnosis was achieved in LVH and in MI in the inferior and anterior left ventricular walls and the interventricular septum. Poor diagnostic score occurred in infarction of high posterior and lateral walls, RVH, and acute cor pulmonale. Initial forces oriented to the left, anteriorly, and interiorly, including left bundle branch block, were associated with a poor diagnostic performance of infarction. The vcg was superior to the ecg. The concomitant presence of LVH did not interfere with the vcg diagnosis of infarction. Concomitant RVH interfered with the vcg diagnosis of LVH, but MI did not. RVH was recognized only in cases with moderate or marked increase in right wall thickness.