Correlation of palpatory observations with the anatomic locus of acute myocardial infarction

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The purpose of this clinical study were to correlate the physiologic findings (mean electric axis, heart rate, and P-Q interval on the electrocardiogram) among three experimental groups (25 subjects with acute myocardial infarction [MI], 15 subjects with heart disease other than MI, and 22 subjects without known cardiovascular disease) and to determine whether there was any correlation between the terminology chosen to describe the somatic component and the location of the infarction site in the myocardium. Statistical evaluations were performed using analysis of variance, Student's t-test, linear correlation test, and chi square test with Yate's correction. P-Q intervals in both the MI group and the excluded group of subjects were significantly longer than P-Q intervals in controls (p < .02 and p < .01, respectively). The elongation of the interval may indicate that patients with cardiac disease require a greater sympathetic neuronal input to their myocardium in connection with somatic motor activation. There is evidence that a prolonged P-Q interval is associated with subsequent sudden death and may, therefore, be useful for its diagnostic significance. There were no significant differences in heart rate or degrees of left/right electric axis deviations among the three groups. The descriptors 'resistant tense firm' and 'temperature warm' were both used with significantly greater frequency when describing the somatic component of anterior wall MI as compared to other infarction sites (posterior wall, inferior wall, or septum). In contrast, the somatic component of inferior wall MI was more difficult to describe and detect.

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Journal of the American Osteopathic Association





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This article was published in Journal of the American Osteopathic Association, Volume 87, Issue 2, Pages 118-122.

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