Congestive heart failure electrocardiogram: Difference between revisions
Jump to navigation
Jump to search
| Line 6: | Line 6: | ||
==Electrocardiographic Abnormalities== | ==Electrocardiographic Abnormalities== | ||
'''[[Low QRS Voltage]]:''' The EKG often shows [[low QRS voltage]]. There are two broad underlying causes of low QRS voltage in the patient with heart failure: | |||
#Electrically inert [[myocardium]] due to a loss of viable [[myocardium]] | #Electrically inert [[myocardium]] due to a loss of viable [[myocardium]] | ||
#Infiltration of the myocardium ([[myxedematous]], [[Chagas disease]]) | #Infiltration of the myocardium ([[myxedematous]], [[Chagas disease]]) | ||
In alphabetical order the differential diagnosis of causes of low QRS voltage in the patient with | In alphabetical order the differential diagnosis of causes of [[low QRS voltage]] in the patient with heart failure includes: | ||
:*[[Amyloidosis]] | :* [[Amyloidosis]] | ||
:*[[Anasarca]]<ref name="pmid18804788">{{cite journal| author=Madias JE| title=Low QRS voltage and its causes. | journal=J Electrocardiol | year= 2008 | volume= 41 | issue= 6 | pages= 498-500 | pmid=18804788 | doi=10.1016/j.jelectrocard.2008.06.021 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18804788 }} </ref> | :* [[Anasarca]]<ref name="pmid18804788">{{cite journal| author=Madias JE| title=Low QRS voltage and its causes. | journal=J Electrocardiol | year= 2008 | volume= 41 | issue= 6 | pages= 498-500 | pmid=18804788 | doi=10.1016/j.jelectrocard.2008.06.021 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18804788 }} </ref> | ||
:*Dilated [[cardiomyopathy]]<ref name="pmid18353352">{{cite journal| author=Chinitz JS, Cooper JM, Verdino RJ| title=Electrocardiogram voltage discordance: interpretation of low QRS voltage only in the limb leads. | journal=J Electrocardiol | year= 2008 | volume= 41 | issue= 4 | pages= 281-6 | pmid=18353352 | doi=10.1016/j.jelectrocard.2007.12.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18353352 }} </ref> | :* Dilated [[cardiomyopathy]]<ref name="pmid18353352">{{cite journal| author=Chinitz JS, Cooper JM, Verdino RJ| title=Electrocardiogram voltage discordance: interpretation of low QRS voltage only in the limb leads. | journal=J Electrocardiol | year= 2008 | volume= 41 | issue= 4 | pages= 281-6 | pmid=18353352 | doi=10.1016/j.jelectrocard.2007.12.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18353352 }} </ref> | ||
:*[[Chagas disease]] | :* [[Chagas disease]] | ||
:* Diffuse [[coronary artery disease]] | :* Diffuse [[coronary artery disease]] | ||
:* [[Congestive heart failure]] | :* [[Congestive heart failure]] | ||
| Line 21: | Line 21: | ||
:* [[Hypothyroidism]] | :* [[Hypothyroidism]] | ||
:* Prior [[myocardial infarction]] | :* Prior [[myocardial infarction]] | ||
:*[[Myocarditis]] | :* [[Myocarditis]] | ||
:*[[Myxedema]] | :* [[Myxedema]] | ||
:* [[Obesity]] | :* [[Obesity]] | ||
:* [[Tamponade]] | :* [[Tamponade]] | ||
'''[[Poor R wave progression]]:''' [[Poor R wave progression]] in the precordial leads may be secondary to a prior [[myocardial infarction]] but can also be observed in the absence of a prior myocardial infarction in the patient with heart failure. | |||
* [[Left bundle branch block]] ([[LBBB]]): can be observed in both ischemic and non-ischemic cases of heart failure | * [[Left bundle branch block]] ([[LBBB]]): can be observed in both ischemic and non-ischemic cases of heart failure | ||
* [[Left ventricular hypertrophy]]: consistent with a history of [[hypertension]] can be seen | * [[Left ventricular hypertrophy]]: consistent with a history of [[hypertension]] can be seen | ||
Revision as of 20:01, 1 April 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Although there is no diagnostic criteria of congestive heart failure on the EKG, there may be signs of the underlying cardiac cause(s) of congestive heart failure.
Electrocardiographic Abnormalities
Low QRS Voltage: The EKG often shows low QRS voltage. There are two broad underlying causes of low QRS voltage in the patient with heart failure:
- Electrically inert myocardium due to a loss of viable myocardium
- Infiltration of the myocardium (myxedematous, Chagas disease)
In alphabetical order the differential diagnosis of causes of low QRS voltage in the patient with heart failure includes:
Poor R wave progression: Poor R wave progression in the precordial leads may be secondary to a prior myocardial infarction but can also be observed in the absence of a prior myocardial infarction in the patient with heart failure.
- Left bundle branch block (LBBB): can be observed in both ischemic and non-ischemic cases of heart failure
- Left ventricular hypertrophy: consistent with a history of hypertension can be seen
- Left atrial enlargement
- Non-specific ST segment and T wave changes
References
- ↑ 1.0 1.1 Madias JE (2008). "Low QRS voltage and its causes". J Electrocardiol. 41 (6): 498–500. doi:10.1016/j.jelectrocard.2008.06.021. PMID 18804788.
- ↑ Chinitz JS, Cooper JM, Verdino RJ (2008). "Electrocardiogram voltage discordance: interpretation of low QRS voltage only in the limb leads". J Electrocardiol. 41 (4): 281–6. doi:10.1016/j.jelectrocard.2007.12.001. PMID 18353352.