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THE EFFECTS OF MITRAL STENOSIS, PULMONIC STENOSIS, AORTIC REGURGITATION AND HYPERTENSION ON THE ELECTROCARDIOGRAM

PAUL D. WHITE, M.D.; C. SIDNEY BURWELL, M.D.
Arch Intern Med (Chic). 1924;34(4):529-532. doi:10.1001/archinte.1924.00120040115010.
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Just seven years ago Dr. Arlie V. Bock and I1 presented before the American Society of Clinical Investigation a report entitled: "Electrocardiographic Evidence of Abnormal Ventricular Preponderance and of Auricular Hypertrophy." That report was based on the electrocardiograms of about 1,000 cases studied in the course of two and one-half years at the Massachusetts General Hospital. Our conclusions were that mitral stenosis and pulmonic stenosis do often affect the electrocardiogram to produce an abnormal swing of the electrical axis of the heart to the right, and that hypertension and aortic regurgitation often cause an abnormal swing of the axis to the left. We used the formula which Lewis2 had suggested in 1914, simply the sum in tenths of a millivolt of the amplitudes of R in Lead I plus S in Lead III minus the sum of S in Lead I plus R in Lead III; that is (Ri +

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