GORDON B. MYERS, M.D., F.A.C.P.; FREDERICK N. TALMERS, M.D.
Myocardial ischemia may be referable to (1) primary reduction in oxygen delivery by the coronary tree; (2) primary increase in cardiac work so that an oxygen supply ordinarily sufficient at rest is no longer adequate; (3) combinations of (1) and (2). Severe prolonged ischemia results in left ventricular infarction, which is manifested by distinctive QRS alterations in leads facing the epicardial surface. These consist of (1) increase in the duration and amplitude of the Q wave at the expense of the succeeding R, provided the septal vector maintains its normal left-to-right direction, or (2) development of incomplete or complete left
MYERS GB, TALMERS FN. THE ELECTROCARDIOGRAPHIC DIAGNOSIS OF ACUTE MYOCARDIAL ISCHEMIA12. Ann Intern Med. ;43:361–382. doi: 10.7326/0003-4819-43-2-361
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Published: Ann Intern Med. 1955;43(2):361-382.
Acute Coronary Syndromes, Cardiology, Coronary Heart Disease, Emergency Medicine.
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