ELECTROCARDIOGRAMS

To the Editor:—  In the August 12 issue of The Journal, Drs. Strouse, Katz and Binswanger discussed a feature of electrocardiographic study which is worthy of reemphasis. Textbooks and the literature have not sufficiently stressed the problem and the significance of basic and serial electrocardiograms. By careful study of patients and graphs one finds that the single picture is usually of no clinical value except as it presents definite diagnostic features. Especially is this true in coronary disease on an arteriosclerotic basis, in which progression of the pathologic condition may take place without clinical exhibition of variation in cardiac disorders or even in symptomatology.It seems that the best way to detect lesions early is by taking the patient's cardiac "fingerprints" and follow these up subsequently; i. e., a routine electrocardiogram of all patients over the age of 40 at the time of a general physical examination. Later follow-ups will help in early diagnosis of the presence or extension of disease by comparative study. It is in coronary disease that this procedure will have inestimable value and possibly help in preventing early or avoidable cardiac morbidity.