Systemic lupus erythematosus electrocardiogram: Difference between revisions

	Systemic lupus erythematosus Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Systemic lupus erythematosus from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Lupus and Quality of Life
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Systemic lupus erythematosus electrocardiogram On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Systemic lupus erythematosus electrocardiogram All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
National Guidelines Clearinghouse
NICE Guidance
FDA on Systemic lupus erythematosus electrocardiogram
on Systemic lupus erythematosus electrocardiogram
Systemic lupus erythematosus electrocardiogram in the news
Blogs onSystemic lupus erythematosus electrocardiogram
Directions to Hospitals Treating Systemic lupus erythematosus
Risk calculators and risk factors for Systemic lupus erythematosus electrocardiogram

VisualWikitext

Revision as of 12:01, 17 August 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The most common and important ECG findings associated with systemic lupus erythematosus (SLE) include sinus tachycardia, ST segment changes, and ventricular conduction disturbances. Other ECG findings are related to late complications of SLE and may range based on the complication.

Electrocardiogram

The most common and important ECG findings associated with systemic lupus erythematosus (SLE) include sinus tachycardia, ST segment changes, and ventricular conduction disturbances. SLE can affect cardiopulmonary system in different ways including pulmonary emboli development, Libman sacks endocarditis, and conduction problems.^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[8]

Important ECG findings in SLE patients based on cardiac complication:

Cardiac complication		ECG findings
Cardiomegaly		Increase in QRS amplitude Widened QRS/T angle Left atrial enlargement Left axis deviation
Libman sacks endocarditis	Heart failure	P wave changes R wave height changes Primary increase Decrease after progression
Libman sacks endocarditis	Myocardial infarction	Due to emboli ST elevation of 2 mm (0.2 mV) in men or 1.5 mm (0.15 mV) in women in V2–V3 and/or of 1 mm (0.1mV) in 2 contiguous chest leads or limb leads ST depression in at least two precordial leads V1-V4 (suggestive of posterior MI) ST depression in several leads plus ST elevation in lead aVR (suggestive of occlusion of the left main or proximal LAD artery) New left bundle branch block (LBBB)
Valvular involvement	Mitral valve stenosis	ECG findings suggestive of left atrial enlargement include: Broad and biphasic P wave in lead II (P mitrale) Enlargement of the terminal negative portion of the P wave in VI P wave amplitude >2.5 mm in inferior leads (II, III, AVF) or >1.5 mm in V1/V2 (P pulmonale)
Valvular involvement	Mitral regurgitation	ECG findings suggestive of left atrial enlargement include: Broad and biphasic P wave in lead II (P mitrale) Enlargement of the terminal negative portion of the P wave in V1 P wave amplitude >2.5 mm in inferior leads (II, III, AVF) or >1.5 mm in V1/V2 (P pulmonale) ECG findings suggestive of left ventricular enlargement include: Increased QRS voltage on ECG Strain pattern Inverted check mark pattern to the T wave in the lateral leads
Arrhythmias	AV Blocks	Incomplete bundle branch block Right bundle branch block Left bundle branch block Left anterior fascicular block Left posterior fascicular block
Arrhythmias	Supraventricular arrhythmias	Premature atrial complexes (PAC) Atrial fibrillation Atrial flutter
Pericardial disease	Acute pericarditis	ST segment depression: Always in aVR Frequently in V1 Occasionally in V2 J point in V6 > 25% of the height of the T wave apex Reduced voltage with quasi-specific ST-T waves due to increase in scar tissue, fluid and fibrin The EKG abnormalities vary depending on the stage/severity of the pericarditis
Pericardial disease	Pericardial effusion	Electrical alternans An electrocardiographic phenomenon of alternation of QRS complex amplitude or axis between beats
Myocarditis		The ECG findings most commonly seen in myocarditis are: Sinus tachycardia Diffuse T wave inversions ST segment elevation without reciprocal depression Low voltage of the QRS complexes Arrhythmias such as atrial or ventricular ectopic beats, atrial or ventricular tachycardias, and atrial fibrillation
Coronary artery disease		Exercise tolerance test findings include: ST segment changes Exercise induced ventricular arrhythmia Hemodynamic changes during the test

References

↑ Bourré-Tessier J, Urowitz MB, Clarke AE, Bernatsky S, Krantz MJ, Huynh T, Joseph L, Belisle P, Bae SC, Hanly JG, Wallace DJ, Gordon C, Isenberg D, Rahman A, Gladman DD, Fortin PR, Merrill JT, Romero-Diaz J, Sanchez-Guerrero J, Fessler B, Alarcón GS, Steinsson K, Bruce IN, Ginzler E, Dooley MA, Nived O, Sturfelt G, Kalunian K, Ramos-Casals M, Petri M, Zoma A, Pineau CA (2015). "Electrocardiographic findings in systemic lupus erythematosus: data from an international inception cohort". Arthritis Care Res (Hoboken). 67 (1): 128–35. doi:10.1002/acr.22370. PMID 24838943.
↑ Tsunakawa H, Miyamoto N, Kawabata M, Mashima S (1993). "[Electrocardiogram in heart failure]". Nippon Rinsho (in Japanese). 51 (5): 1222–32. PMID 8331790.
↑ Maganti K, Rigolin VH, Sarano ME, Bonow RO (2010). "Valvular heart disease: diagnosis and management". Mayo Clin Proc. 85 (5): 483–500. doi:10.4065/mcp.2009.0706. PMC 2861980. PMID 20435842.
↑ TROUNCE JR (1952). "The electrocardiogram in mitral stenosis". Br Heart J. 14 (2): 185–92. PMC 479442. PMID 14916061.
↑ Nakashima H, Honda Y, Katayama T (1994). "Serial electrocardiographic findings in acute myocarditis". Intern. Med. 33 (11): 659–66. PMID 7849377.
↑ Feldman AM, McNamara D (2000). "Myocarditis". N Engl J Med. 343 (19): 1388–98. doi:10.1056/NEJM200011093431908. PMID 11070105.
↑ Troughton RW, Asher CR, Klein AL (2004). "Pericarditis". Lancet. 363 (9410): 717–27. doi:10.1016/S0140-6736(04)15648-1. PMID 15001332.
↑ Spodick DH (2003). "Acute pericarditis: current concepts and practice". JAMA. 289 (9): 1150–3. doi:10.1001/jama.289.9.1150. PMID 12622586.

Template:WH Template:WS

[pmid24838943-1] Bourré-Tessier J, Urowitz MB, Clarke AE, Bernatsky S, Krantz MJ, Huynh T, Joseph L, Belisle P, Bae SC, Hanly JG, Wallace DJ, Gordon C, Isenberg D, Rahman A, Gladman DD, Fortin PR, Merrill JT, Romero-Diaz J, Sanchez-Guerrero J, Fessler B, Alarcón GS, Steinsson K, Bruce IN, Ginzler E, Dooley MA, Nived O, Sturfelt G, Kalunian K, Ramos-Casals M, Petri M, Zoma A, Pineau CA (2015). "Electrocardiographic findings in systemic lupus erythematosus: data from an international inception cohort". Arthritis Care Res (Hoboken). 67 (1): 128–35. doi:10.1002/acr.22370. PMID 24838943.

[pmid8331790-2] Tsunakawa H, Miyamoto N, Kawabata M, Mashima S (1993). "[Electrocardiogram in heart failure]". Nippon Rinsho (in Japanese). 51 (5): 1222–32. PMID 8331790.

[pmid20435842-3] Maganti K, Rigolin VH, Sarano ME, Bonow RO (2010). "Valvular heart disease: diagnosis and management". Mayo Clin Proc. 85 (5): 483–500. doi:10.4065/mcp.2009.0706. PMC 2861980. PMID 20435842.

[pmid14916061-4] TROUNCE JR (1952). "The electrocardiogram in mitral stenosis". Br Heart J. 14 (2): 185–92. PMC 479442. PMID 14916061.

[pmid7849377-5] Nakashima H, Honda Y, Katayama T (1994). "Serial electrocardiographic findings in acute myocarditis". Intern. Med. 33 (11): 659–66. PMID 7849377.

[pmid110701052-6] Feldman AM, McNamara D (2000). "Myocarditis". N Engl J Med. 343 (19): 1388–98. doi:10.1056/NEJM200011093431908. PMID 11070105.

[troughton-7] Troughton RW, Asher CR, Klein AL (2004). "Pericarditis". Lancet. 363 (9410): 717–27. doi:10.1016/S0140-6736(04)15648-1. PMID 15001332.

[spodick-8] Spodick DH (2003). "Acute pericarditis: current concepts and practice". JAMA. 289 (9): 1150–3. doi:10.1001/jama.289.9.1150. PMID 12622586.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

@@ Line 7: / Line 7: @@
 ==Electrocardiogram==
-The most common and important [[ECG]] findings associated with systemic lupus erythematosus (SLE) include [[sinus tachycardia]], [[ST segment changes]], and [[Ventricular arrhythmias|ventricular conduction disturbances]]. SLE can affect [[cardiopulmonary]] system in different ways including [[Pulmonary embolism|pulmonary emboli development]], [[Libman-Sacks disease|Libman sacks endocarditis]], and conduction problems. <ref name="pmid24838943">{{cite journal |vauthors=Bourré-Tessier J, Urowitz MB, Clarke AE, Bernatsky S, Krantz MJ, Huynh T, Joseph L, Belisle P, Bae SC, Hanly JG, Wallace DJ, Gordon C, Isenberg D, Rahman A, Gladman DD, Fortin PR, Merrill JT, Romero-Diaz J, Sanchez-Guerrero J, Fessler B, Alarcón GS, Steinsson K, Bruce IN, Ginzler E, Dooley MA, Nived O, Sturfelt G, Kalunian K, Ramos-Casals M, Petri M, Zoma A, Pineau CA |title=Electrocardiographic findings in systemic lupus erythematosus: data from an international inception cohort |journal=Arthritis Care Res (Hoboken) |volume=67 |issue=1 |pages=128–35 |year=2015 |pmid=24838943 |doi=10.1002/acr.22370 |url=}}</ref><ref name="pmid8331790">{{cite journal |vauthors=Tsunakawa H, Miyamoto N, Kawabata M, Mashima S |title=[Electrocardiogram in heart failure] |language=Japanese |journal=Nippon Rinsho |volume=51 |issue=5 |pages=1222–32 |year=1993 |pmid=8331790 |doi= |url=}}</ref><ref name="pmid20435842">{{cite journal| author=Maganti K, Rigolin VH, Sarano ME, Bonow RO| title=Valvular heart disease: diagnosis and management. | journal=Mayo Clin Proc | year= 2010 | volume= 85 | issue= 5 | pages= 483-500 | pmid=20435842 | doi=10.4065/mcp.2009.0706 | pmc=2861980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20435842  }}</ref><ref name="pmid14916061">{{cite journal| author=TROUNCE JR| title=The electrocardiogram in mitral stenosis. | journal=Br Heart J | year= 1952 | volume= 14 | issue= 2 | pages= 185-92 | pmid=14916061 | doi= | pmc=479442 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14916061  }}</ref><ref name="pmid7849377">{{cite journal |vauthors=Nakashima H, Honda Y, Katayama T |title=Serial electrocardiographic findings in acute myocarditis |journal=Intern. Med. |volume=33 |issue=11 |pages=659–66 |year=1994 |pmid=7849377 |doi= |url=}}</ref><ref name="pmid110701052">{{cite journal| author=Feldman AM, McNamara D|title=Myocarditis. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 19 | pages= 1388-98 | pmid=11070105 |doi=10.1056/NEJM200011093431908 | pmc= | url= }}</ref><ref name="troughton">{{cite journal | author=     Troughton RW, Asher CR, Klein AL | title=    Pericarditis | journal=  Lancet| year=2004| pages=717–27 | volume=363 | issue=9410 | pmid=15001332 | doi=    10.1016/S0140-6736(04)15648-1}}</ref><ref name="spodick">{{cite journal | author=  Spodick DH | title= Acute pericarditis: current concepts and practice | journal= JAMA | year=2003 | pages=1150–3 | volume=289 | issue=9 | pmid=12622586 | doi= 10.1001/jama.289.9.1150}}</ref>
+The most common and important [[ECG]] findings associated with systemic lupus erythematosus (SLE) include [[sinus tachycardia]], [[ST segment changes]], and [[Ventricular arrhythmias|ventricular conduction disturbances]]. SLE can affect [[cardiopulmonary]] system in different ways including [[Pulmonary embolism|pulmonary emboli development]], [[Libman-Sacks disease|Libman sacks endocarditis]], and conduction problems.<ref name="pmid24838943">{{cite journal |vauthors=Bourré-Tessier J, Urowitz MB, Clarke AE, Bernatsky S, Krantz MJ, Huynh T, Joseph L, Belisle P, Bae SC, Hanly JG, Wallace DJ, Gordon C, Isenberg D, Rahman A, Gladman DD, Fortin PR, Merrill JT, Romero-Diaz J, Sanchez-Guerrero J, Fessler B, Alarcón GS, Steinsson K, Bruce IN, Ginzler E, Dooley MA, Nived O, Sturfelt G, Kalunian K, Ramos-Casals M, Petri M, Zoma A, Pineau CA |title=Electrocardiographic findings in systemic lupus erythematosus: data from an international inception cohort |journal=Arthritis Care Res (Hoboken) |volume=67 |issue=1 |pages=128–35 |year=2015 |pmid=24838943 |doi=10.1002/acr.22370 |url=}}</ref><ref name="pmid8331790">{{cite journal |vauthors=Tsunakawa H, Miyamoto N, Kawabata M, Mashima S |title=[Electrocardiogram in heart failure] |language=Japanese |journal=Nippon Rinsho |volume=51 |issue=5 |pages=1222–32 |year=1993 |pmid=8331790 |doi= |url=}}</ref><ref name="pmid20435842">{{cite journal| author=Maganti K, Rigolin VH, Sarano ME, Bonow RO| title=Valvular heart disease: diagnosis and management. | journal=Mayo Clin Proc | year= 2010 | volume= 85 | issue= 5 | pages= 483-500 | pmid=20435842 | doi=10.4065/mcp.2009.0706 | pmc=2861980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20435842  }}</ref><ref name="pmid14916061">{{cite journal| author=TROUNCE JR| title=The electrocardiogram in mitral stenosis. | journal=Br Heart J | year= 1952 | volume= 14 | issue= 2 | pages= 185-92 | pmid=14916061 | doi= | pmc=479442 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14916061  }}</ref><ref name="pmid7849377">{{cite journal |vauthors=Nakashima H, Honda Y, Katayama T |title=Serial electrocardiographic findings in acute myocarditis |journal=Intern. Med. |volume=33 |issue=11 |pages=659–66 |year=1994 |pmid=7849377 |doi= |url=}}</ref><ref name="pmid110701052">{{cite journal| author=Feldman AM, McNamara D|title=Myocarditis. | journal=N Engl J Med | year= 2000 | volume= 343 | issue= 19 | pages= 1388-98 | pmid=11070105 |doi=10.1056/NEJM200011093431908 | pmc= | url= }}</ref><ref name="troughton">{{cite journal | author=     Troughton RW, Asher CR, Klein AL | title=    Pericarditis | journal=  Lancet| year=2004| pages=717–27 | volume=363 | issue=9410 | pmid=15001332 | doi=    10.1016/S0140-6736(04)15648-1}}</ref><ref name="spodick">{{cite journal | author=  Spodick DH | title= Acute pericarditis: current concepts and practice | journal= JAMA | year=2003 | pages=1150–3 | volume=289 | issue=9 | pmid=12622586 | doi= 10.1001/jama.289.9.1150}}</ref>
 === Important ECG findings in SLE patients based on cardiac complication: ===