Hemodynamic Correlations of the Electrocardiographic Pattern of Left Ventricular Hypertrophy, "Diastolic Overloading"

¹ Division of Cardiology, Department of Medicine, The Mount Sinai Hospital
² Assistant Attending in Medicine for Cardiology

This study in 43 cases of isolated ventricular septal defect was designed to evaluate the usefulness of the electrocardiogram in predicting the hemodynamic findings in this defect, with specific emphasis on the electrocardiographic pattern of "diastolic overloading" in left ventricular hypertrophy.

Patients in this series with isolated LVH, D.O. as well as those with normal electrocardiograms, had normal or slightly elevated pulmonary artery pressures and small to moderate left-to-right shunts. Patients with LVH, D.O. plus RVH had moderately elevated pulmonary artery pressures and moderate to large left-to-right shunts. Whenever right ventricular pressure exceeded 60 mm. Hg, LVH, D.O. pattern no longer appeared. Patients with advanced RVH and combined hypertrophy without evidence of LVH, D.O. had moderate to marked pulmonary hypertension.

The pattern of LVH, D.O. is a distinct entity in isolated ventricular septal defect. Certain generalizations can be made regarding the relationship of the electrocardiogram with hemodynamic findings in ventricular septal defect; however, no completely predictable correlation could be demonstrated.