The Electrocardiogram in Pulmonary Valve Stenosis with Intact Ventricular Septum.

It has been stated that the electrocardiogram in pulmonary valve stenosis gives an accurate estimate of right ventricular systolic pressure. Nadas (1957) writes "we have not found any patient with a right ventricular systolic pressure of more than 100 mm. of Hg who has not demonstrated at least one of the following three important electrocardiographic criteria: (1) RVY of more than 20 mms., (2) P pulmonale and (3) changes in the ST segment and T wave through V4. Furthermore, once any of these features are noted, the chances that the pressure in the right ventricle is high, are good." De Pasquale and Burch (1960) and Engle et al. (1960) report similar findings. We have had reason to doubt the value of the cardiogram in the prediction of right ventricular systolic pressure. The present study was, therefore, undertaken.