[Tall R waves in the right precordial leads as a possible expression of left septal fascicular block].

Histological, physiological and pathophysiological studies have shown that the left bundle branch mainly divides into three fascicles, and a septal (middle) fascicle is present in over half of human hearts. Electrocardiographic criteria for the diagnosis of the block of this fascicle have been suggested by some authors: tall R waves in lead V2 and sometimes in V1 in the absence of a right bundle branch block pattern or a well evident jump of R waves from V1 to V2, absence of initial septal q waves and/or possible small q waves in the right precordial leads, normal QRS duration and normal QRS axis. At present, this intraventricular block can only be suspected but not diagnosed with certainty even after clinical/instrumental exclusion of pathological situations associated with tall R waves in leads V1 and V2 (right ventricular hypertrophy, lateral infarction, severe septal hypertrophy) because of the marked variability of normal ECG and the potential presence of confounding diseases.

Intermittent isolated anterior displacement of QRS complex - Differential diagnosis.

Background: The proposed criteria for diagnosis of left septal (middle) fascicular block (LSFB) appear to be conflicting. Moreover, it has been claimed that isolated anterior displacement (AD) of QRS complex could be a manifestation of a conduction delay of the right bundle branch, besides of LSFB. The purpose of the present study was to better define the etiology of AD through an analysis of the case reports dealing with intermittent AD, published up to now.

In industrialized nations, a low socioeconomic status represents an independent predictor of mortality in patients with acute myocardial infarction.

Background: It has been widely demonstrated that in the general population a low socioeconomic status (SES) represents a risk factor for coronary heart disease (CHD). Both the incidence of and the mortality due to CHD are significantly higher in subjects with a low SES. Conventional risk factors only partly account for the social gradient in CHD.

[The role of the echo-dipyridamole test in the diagnosis of coronary disease in patients with associated aortic stenosis].

Background: Coronary vasodilator reserve is often significantly impaired in patients with aortic stenosis by several mechanisms: coronary artery disease, left ventricular hypertrophy, increase in cardiac chamber stiffness. The aim of this study was to evaluate the feasibility and the diagnostic accuracy of the dipyridamole echocardiography test in the diagnosis of coronary artery disease in patients with aortic stenosis.

Methods: Forty patients (26 males, 14 females, mean age 69 +/- 8.