Chronic hypertension electrocardiogram
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
An electrocardiogram (EKG/ECG) is obtained in the patients with hypertension to evaluate for the presence of left ventricular hypertrophy or silent myocardial infarction.
Electrocardiogram
A 12-lead electrocardiogram (ECG) is an important part of the work-up in all patients with hypertension. Although and ECG has low sensitivity in detecting LVH, the Sokolow-Lyon index (S in V1 + R in V5>3.5 mV), the modified Sokolow-Lyon index (largest S-wave + largest R-wave >3.5 mV), RaVL >1.1 mV, or Cornell voltage QRS duration product (>244mVms) were all shown to be an independent predictor of CV events particularly in patients aged 55 or more. An ECG is also helpful in detecting signs of ventricular strain, conduction anomalies, ischemia, atrial dilatation and arrhythmias, including atrial fibrillation all of which indicate a greater cardiovascular risk profile.[1]
2013 ESH/ESC Guidelines For The Management of Arterial Hypertension (DO NOT EDIT)[2]
Summary of Recommendations on The Search for Asymptomatic Cardiovascular Disease (DO NOT EDIT)[2]
| Class I |
| "1. An ECG is recommended in all hypertensive patients to detect LVH, left atrial dilatation, arrhythmias, or concomitant heart disease. (Level of Evidence: B)" |
| "2. Whenever history suggests myocardial ischaemia, a stress ECG test is recommended, and, if positive or ambiguous, an imaging stress test (stress echocardiography, stress cardiac magnetic resonance or nuclear scintigraphy) is recommended. (Level of Evidence: C)" |
| Class IIa |
| "1. In all patients with a history or physical examination suggestive of major arrhythmias, long-term ECG monitoring, and, in case of suspected exercise-induced arrhythmias, a stress ECG test should be considered. (Level of Evidence: C)" |
References
- ↑ Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M; et al. (2013). "2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)". J Hypertens. 31 (7): 1281–357. doi:10.1097/01.hjh.0000431740.32696.cc. PMID 23817082.
- ↑ 2.0 2.1 Authors/Task Force Members. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A; et al. (2013). "2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)". Eur Heart J. 34 (28): 2159–219. doi:10.1093/eurheartj/eht151. PMID 23771844.