Clinical electrocardiography . TER VIII Ventricular Preponderance and the Electrocardiogram 115 CHAPTER IX Abnormalities of the T Wave 120 Positive T Wave of High Amplitude 120 T Wave Negativity * 121 Diseases Associated with T Wave Negativity 129 Cardiac Mortality and T Wave Negativity 132 CHAPTER X Abnormalities of the P Wave 135 Exaggerated Amplitude of the P Wave 135 Notching of the P Wave 136 Negative P Wave (Inverted) 136 CHAPTER XI Congenital Heart Disease 139 Congenital Dextrocardia (Right-sided Heart) 140 Congenital Pulmonic Stenosis 142 Congenital Aortic Stenosis 143 Patent Foramen O
Clinical electrocardiography . TER VIII Ventricular Preponderance and the Electrocardiogram 115 CHAPTER IX Abnormalities of the T Wave 120 Positive T Wave of High Amplitude 120 T Wave Negativity * 121 Diseases Associated with T Wave Negativity 129 Cardiac Mortality and T Wave Negativity 132 CHAPTER X Abnormalities of the P Wave 135 Exaggerated Amplitude of the P Wave 135 Notching of the P Wave 136 Negative P Wave (Inverted) 136 CHAPTER XI Congenital Heart Disease 139 Congenital Dextrocardia (Right-sided Heart) 140 Congenital Pulmonic Stenosis 142 Congenital Aortic Stenosis 143 Patent Foramen Ovale 144 Interventricular Septum Defect 145 Patent Ductus Arteriosus (Botalli) 147 CHAPTER XII Electrocardiographic Study of Miscellaneous Heart Diseases 149 Chronic Endocardial Valvular Diseases 149 Index 183 APR 6 - 1922 CLINICALELECTROCARDIOGRAPHY CHAPTER IPHYSIOLOGIC CONSIDERATIONS The muscle of the heart differs anatomically and physiologicallyfrom skeletal muscle. The fibers are striated, interspersed with Lateral Nucleus of Nucleus of Intercalateda muscle a connective disc, fiber. tissue cell. Fig. 1.—A longitudinal section of a papillary muscle of the human heart. X 360, (After Stohr.) very little connective tissue, and their bundles freely anastomose (Fig. 1). Three physiologic characteristics distinguish heart2 17 18 CLINICAL ELECTROCARDIOGRAPHY muscle from other muscle: (1) heart muscle is constantly under-going rhythmic contraction; (2) the response of heart muscle tostimuli is not proportionate but always maximal, constitutingthe all or none law of Bowditch, and (3) heart muscle in thestate of contraction is insensitive to further stimulation, and issaid to be in the refractory stage (Marey). FUNDAMENTAL PROPERTIES OF HEART MUSCLE The fundamental properties of heart muscle are: (1) rhythm-icity, the power of impulse production; (2) irritability, the powerclinicalelectroc00will
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