A ballistocardiographic and electrocardiographic study of 328 patients with coronary artery disease; comparison with results from similar study of apparently normal persons.

Abstract 1. 1. One hundred thirty-seven cases of old myocardial infarction and one hundred ninety-one cases of angina pectoris were studied by both ballistocardiography and electrocardiography. Results were compared with those from a similar study of three hundred sixty-nine clinically normal subjects. 2. 2. Sixty-nine per cent of patients with old myocardial infarction had abnormal electrocardiograms and 72 per cent had abnormal ballistocardiograms. The incidence of abnormal electrocardiograms and ballistocardiograms was significantly higher in each age decade for the patients with old myocardial infarction than for the normal subjects. There was an increasing frequency of ballistic abnormality with age, ranging from 38 per cent in the fourth decade to 96 per cent in the seventh decade. 3. 3. Twenty-four per cent of patients with angina pectoris had abnormal electrocardiograms whereas 75 per cent of them had abnormal ballistocardiograms. The percentage of abnormal ballistocardiograms was significantly higher than that for abnormal electrocardiograms in the fifth, sixth, seventh, and eighth decades. There was an increasing frequency of ballistic abnormality with age, ranging from 45 per cent in the fourth decade to 100 per cent in the eighth decade. In a small group of patients with normal or borderline ballistocardiograms and electrocardiograms, the “two-step” exercise test produced ballistic abnormality in 60 per cent, and a positive electrocardiographic response in 30 per cent. 4. 4. Detailed quantitative analysis of the normal and borderline ballistocardiograms from normal subjects and from patients with coronary artery disease failed to reveal any important differences between the two clinical groups. 5. 5. In the age groups in which the incidence of ballistic abnormality was low for clinically normal subjects it was also low for patients with coronary artery disease, and in those age groups in which the incidence of ballistic abnormality was high for patients with coronary artery disease it was also high for clinically normal subjects. It is suggested that significance be attached to abnormal ballistocardiograms from subjects under the age of 50 and to normal ballistocardiograms from those over the age of 60. 6. 6. It is recommended that, for the present, caution be used in attributing clinical significance to abnormal ballistocardiograms from clinically normal persons and from patients whose symptoms and signs are not typical of coronary artery disease. 7. 7. The literature is reviewed with respect to the use of ballistocardiography in coronary artery disease.

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