Aortic regurgitation electrocardiogram: Difference between revisions
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{{Aortic insufficiency}} | {{Aortic insufficiency}} | ||
{{CMG}}; {{AE}} {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S | {{CMG}}; {{AE}} {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S; {{USAMA}} | ||
==Overview== | ==Overview== | ||
In aortic regurgitation, the electrocardiography findings are nonspecific. Electrocardiographic abnormalities in the patient with aortic regurgitation include [[left axis deviation]] and signs of [[left ventricular hypertrophy]].<ref name=" | In aortic regurgitation, the [[EKG|electrocardiography]] findings are nonspecific. [[The electrocardiogram|Electrocardiographic]] abnormalities in the patient with aortic regurgitation include [[left axis deviation]] and signs of [[left ventricular hypertrophy]].<ref name="pmid9870202">{{cite journal| author=Bonow RO, Carabello B, de Leon AC, Edmunds LH, Fedderly BJ, Freed MD et al.| title=ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). | journal=J Heart Valve Dis | year= 1998 | volume= 7 | issue= 6 | pages= 672-707 | pmid=9870202 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9870202 }} </ref> | ||
==Electrocardiogram== | ==Electrocardiogram== | ||
Electrocardiographic abnormalities in the patient with aortic regurgitation include:<ref name=" | [[The electrocardiogram|Electrocardiographic]] abnormalities in the patient with aortic regurgitation include:<ref name="pmid9870202">{{cite journal| author=Bonow RO, Carabello B, de Leon AC, Edmunds LH, Fedderly BJ, Freed MD et al.| title=ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). | journal=J Heart Valve Dis | year= 1998 | volume= 7 | issue= 6 | pages= 672-707 | pmid=9870202 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9870202 }} </ref><ref name="pmid24939033">{{cite journal| author=Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA et al.| title=2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. | journal=J Thorac Cardiovasc Surg | year= 2014 | volume= 148 | issue= 1 | pages= e1-e132 | pmid=24939033 | doi=10.1016/j.jtcvs.2014.05.014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24939033 }} </ref><ref name="pmid26805657">{{cite journal| author=Petit CJ, Gao K, Goldstein BH, Lang SM, Gillespie SE, Kim SI et al.| title=Relation of Aortic Valve Morphologic Characteristics to Aortic Valve Insufficiency and Residual Stenosis in Children With Congenital Aortic Stenosis Undergoing Balloon Valvuloplasty. | journal=Am J Cardiol | year= 2016 | volume= 117 | issue= 6 | pages= 972-9 | pmid=26805657 | doi=10.1016/j.amjcard.2015.12.034 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26805657 }} </ref> | ||
* Nonspecific changes of ST and T wave (due to [[left ventricular]] enlargement) | * Nonspecific changes of [[ST interval|ST]] and [[T wave]] (due to [[left ventricular]] enlargement) | ||
* [[Right coronary artery]] ischemic changes (suggestive of [[aortic dissection]]) | * [[Right coronary artery]] ischemic changes (suggestive of [[aortic dissection]]) | ||
** ST elevation in II, III, aVF ([[inferior MI]]) | **[[ST elevation]] in II, III, aVF ([[inferior MI]]) | ||
** ST elevation in V3R and V4R ([[right ventricle MI]]) | **[[ST elevation]] in V3R and V4R ([[right ventricle MI]]) | ||
** ST depression in V1-V3 ([[posterior MI]]) | **[[ST depression]] in V1-V3 ([[posterior MI]]) | ||
*[[Left ventricular hypertrophy]] | *[[Left ventricular hypertrophy]] | ||
*[[Left axis deviation]] | *[[Left axis deviation]] | ||
*[[Left atrial enlargement]] | *[[Left atrial enlargement]] | ||
*Left ventricular volume overload pattern (prominent [[Q wave]]s in leads [[Electrocardiogram|I]], [[Electrocardiogram|aVL]], and [[Electrocardiogram#Precordial|V3]] to [[Electrocardiogram#Precordial|V6]] and relatively small [[R wave]]s in [[Electrocardiogram#Precordial|V1]]) | *[[Left ventricular]] volume overload pattern (prominent [[Q wave]]s in leads [[Electrocardiogram|I]], [[Electrocardiogram|aVL]], and [[Electrocardiogram#Precordial|V3]] to [[Electrocardiogram#Precordial|V6]] and relatively small [[R wave]]s in [[Electrocardiogram#Precordial|V1]]) | ||
*Left ventricular conduction defects (typically late in the disease process) | *[[Left ventricular]] conduction defects (typically late in the disease process) | ||
*Re-polarization abnormalities | *Re-polarization abnormalities | ||
*[[ST-segment]] depression in precordial leads | *[[ST-segment]] depression in precordial leads | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S; Usama Talib, BSc, MD [3]
Overview
In aortic regurgitation, the electrocardiography findings are nonspecific. Electrocardiographic abnormalities in the patient with aortic regurgitation include left axis deviation and signs of left ventricular hypertrophy.[1]
Electrocardiogram
Electrocardiographic abnormalities in the patient with aortic regurgitation include:[1][2][3]
- Nonspecific changes of ST and T wave (due to left ventricular enlargement)
- Right coronary artery ischemic changes (suggestive of aortic dissection)
- ST elevation in II, III, aVF (inferior MI)
- ST elevation in V3R and V4R (right ventricle MI)
- ST depression in V1-V3 (posterior MI)
- Left ventricular hypertrophy
- Left axis deviation
- Left atrial enlargement
- Left ventricular volume overload pattern (prominent Q waves in leads I, aVL, and V3 to V6 and relatively small R waves in V1)
- Left ventricular conduction defects (typically late in the disease process)
- Re-polarization abnormalities
- ST-segment depression in precordial leads
Shown below is an ECG depicting left ventricular hypertrophy. Copyleft image obtained courtesy of ECGpedia [4]
Shown below is an ECG depicting left axis deviation. Copyleft image obtained courtesy of ECGpedia [5]
References
- ↑ 1.0 1.1 Bonow RO, Carabello B, de Leon AC, Edmunds LH, Fedderly BJ, Freed MD; et al. (1998). "ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease)". J Heart Valve Dis. 7 (6): 672–707. PMID 9870202.
- ↑ Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Thorac Cardiovasc Surg. 148 (1): e1–e132. doi:10.1016/j.jtcvs.2014.05.014. PMID 24939033.
- ↑ Petit CJ, Gao K, Goldstein BH, Lang SM, Gillespie SE, Kim SI; et al. (2016). "Relation of Aortic Valve Morphologic Characteristics to Aortic Valve Insufficiency and Residual Stenosis in Children With Congenital Aortic Stenosis Undergoing Balloon Valvuloplasty". Am J Cardiol. 117 (6): 972–9. doi:10.1016/j.amjcard.2015.12.034. PMID 26805657.