Aortic regurgitation electrocardiogram: Difference between revisions

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| [[Aortic regurgitation resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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{{Aortic insufficiency}}
{{Aortic insufficiency}}
 
{{CMG}}; {{AE}} {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S; {{USAMA}}
{{CMG}}; '''Associate Editor-in-Chief:''' {{CZ}}, [[Varun Kumar]], M.B.B.S., [[Lakshmi Gopalakrishnan]], M.B.B.S.


==Overview==
==Overview==
Electrocardiographic abnormalities in the patient with aortic insufficiency include [[left ventricular hypertrophy]] and [[left axis deviation]].
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==
In aortic insufficiency, the electrocardiographic findings are nonspecific. However, the following may be noted:
[[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 interval|ST]] and [[T wave]] (due to [[left ventricular]] enlargement)
* [[Left ventricular hypertrophy]]
* [[Right coronary artery]] ischemic changes (suggestive of [[aortic dissection]])
[[Image:LVH.png|left|300px|[[Left ventricular hypertrophy]]]]
**[[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 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)
 
*Re-polarization abnormalities
 
*[[ST-segment]] depression in precordial leads
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
* Left axis deviation
[[Image:679px-LHA.png|left|350px|[[Left axis deviation]]]]
 
 
 
 
 
 
 
 
 
 


Shown below is an ECG depicting [[left ventricular hypertrophy]].  Copyleft image obtained courtesy of ECGpedia [http://en.ecgpedia.org/wiki/Main_Page]


[[Image:LVH.png|left|350px|Left ventricular hypertrophy]]
<br clear="left"/>


----


Shown below is an ECG depicting [[left axis deviation]].  Copyleft image obtained courtesy of ECGpedia [http://en.ecgpedia.org/wiki/Main_Page]


 
[[Image:679px-LHA.png|left|350px|Left axis deviation]]
 
<br clear="left"/>
 
 
 
 
 
 
 
 
 
* [[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)
* Repolarization abnormalities
* ST-segment depression in precordial leads


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
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[[CME Category::Cardiology]]
[[Category:Disease]]
[[Category:Cardiology]]
[[Category:Valvular heart disease]]
[[Category:Congenital heart disease]]
[[Category:Surgery]]
[[Category:Cardiac surgery]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Up-To-Date cardiology]]
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Latest revision as of 21:23, 20 February 2020
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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]

Shown below is an ECG depicting left ventricular hypertrophy. Copyleft image obtained courtesy of ECGpedia [4]

Left ventricular hypertrophy
Left ventricular hypertrophy


Shown below is an ECG depicting left axis deviation. Copyleft image obtained courtesy of ECGpedia [5]

Left axis deviation
Left axis deviation


References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.

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