John J. Sampson

A study of Lead IV of the electrocardiogram in children with especial reference to the direction of excursion of the T-wave

Abstract Electrocardiograms were made on a group of fifty normal children, and particular attention was paid to the character of the T-wave in Lead IV. A control group of tracings was made from sixty-six adults who had no demonstrable heart disease and in whom the electrocardiograms were within normal limits. Sixty-four per cent of the tracings of the fifty normal children showed an upright T 4 -wave; 32 per cent exhibited a diphasic or an isoelectric T 4 , and in only 4 per cent of the cases was the T 4 inverted. No relationship between the direction of the electrical axis and that of the T 4 -wave was discoverable. The inverted T 4 , normal in adult life, is of rare occurrence in the electrocardiograms of normal children, while the upright excursion of T 4 in the electrocardiogram of a child is a normal phenomenon.

Phonocardiography of the human fetus

Abstract From our work evidence has been obtained of the variability of normal heart sounds before and after birth. An early systolic murmur is almost universal in early infancy, according to our criteria for the recognition of a murmur. Among thirty-three subjects upon whom fetal heart sound observations were made, twelve presented no murmurs, seventeen showed an early systolic murmur only. Seven showed other systolic and diastolic murmurs which apparently could not be used as indications of congenital heart lesions as seen after birth, and may represent currents through the patent foramen ovale and ductus arteriosus. One case illustrated certain criteria of a congenital heart lesion before birth. These criteria agreed in general with those of Hoehne but were more specific in recognition of the particular valve lesion noted in this case, namely pulmonic stenosis. The unique feature of this case was a high-pitched murmur throughout the whole of systole. This was totally unlike any of the murmurs recorded by us either in children or adults in cases other than those diagnosed clinically as classical pulmonic stenosis. A surprising fact disclosed in this investigation was that in the normal fetus with a patent foramen ovale and ductus arteriosus, murmurs were not consistently found. Presumably it requires either abnormal pressure relationships, developmental defects occurring relatively early in intrauterine life, or both, to produce the auditory signs of a congenital lesion of the recognizable patent ductus arteriousus type as seen after birth. This theory is not original but receives support from the observations here recorded.