JOHN W. STARR, M.D.; J. FRED MCNEER, M.D.; RAYMOND E. IDEKER, M.D.; GALEN S. WAGNER, M.D.
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To the editor: We read with great interest the review by Madias and Gorlin, "The Myth of Acute 'Mild' Myocardial Infarction" (Ann Intern Med 86:347-352, 1977). We agree with their conclusion that the standard electrocardiogram alone is a very insensitive means of diagnosing old or acute myocardial infarction and assessing the severity of that infarction in terms of early or late prognosis. This is certainly an important concept. Certain other points, however, need to be made.
First, there is no reference to the superior sensitivity of the vectorcardiogram in detecting QRS changes and extent of infarction (1, 2). As stated
STARR JW, MCNEER JF, IDEKER RE, et al. Mild Myocardial Infarction. Ann Intern Med. 1977;87:118–119. doi: 10.7326/0003-4819-87-1-118
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Published: Ann Intern Med. 1977;87(1):118-119.
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