Effect of Meals on the Electrocardiogram of Cardiac Patients. ∗

Abstract

In a previous communication, 1 we reported, for 12 normal men, the effect of meals on electrocardiograms recorded 30 and 60 minutes later. Most of the electrocardiographic functions, especially the T-wave, showed statistically significant changes, although the electrocardiograms remained within clinically normal limits. In 20 cardiac patients, mostly definite or suspected coronary disease, we recorded the standard limb leads, 3 chest leads (CF₁, CF₂, CF₄) and the heart sounds before and at 30 and 60 minutes after a 1000-calorie meal. In 2 patients additional chest leads were taken. The location for the chest leads was marked on the chest by means of a colored pencil.

Out of 10 patients with some symptoms of angina pectoris but with normal electrocardiogram before the meal and without any signs of decompensation, the electrocardiogram became abnormal after the meal. The abnormality involved inversion of the T-wave in lead CF₂ or CF₄ or increase in the size of a Q-wave in lead III. These patients felt no discomfort after the meal.

In 5 patients with coronary disease and abnormal elecrocardiogram before the meal, the electrocardiogram became more abnormal with inversion of the T-wave in leads 1, 2 or CF.₄ Slight changes of the QRS-contour were also observed. In one patient, a transitory pulsus trigreminus appeared after the meal.

In 5 patients nith coronarq disease and abnormal electrocardiogrdm before the meal, the electrocdrdiogram became more abnormal with i111erbion of the T-wave in leads 1, 2 CF₄ Slight chances of the QRS-contour were also observed. In one patient, a transitory pulsus trigreminus appeared after the meal.

In 2 patients nith abnormal electrocardio before the medl the cheat leads ap-peared to be more normal after the meal; previously imerted T-waves in CF₂ and CF₄became positive. Similar changes hake been obaerled niter exercise in colonary patients and cannot be interpreted as a sign of improvement