Systemic lupus erythematosus electrocardiogram: Difference between revisions
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| colspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Cardiac complication | | colspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Cardiac complication | ||
| align="center" style="background: #4479BA; color: #FFFFFF; " |ECG findings | | align="center" style="background: #4479BA; color: #FFFFFF; " |ECG findings | ||
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| colspan="2" style="background: #DCDCDC; " |[[Cardiomegaly]] | | colspan="2" style="background: #DCDCDC; " |[[Cardiomegaly]] | ||
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* [[Left Atrial Enlargement|Left atrial enlargement]] | * [[Left Atrial Enlargement|Left atrial enlargement]] | ||
* [[Left axis deviation]] | * [[Left axis deviation]] | ||
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| rowspan="2" style="background: #DCDCDC; " |[[Libman-Sacks endocarditis|Libman sacks endocarditis]] | | rowspan="2" style="background: #DCDCDC; " |[[Libman-Sacks endocarditis|Libman sacks endocarditis]] | ||
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** Primary increase | ** Primary increase | ||
** Decrease after progression | ** Decrease after progression | ||
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| style="background: #DCDCDC; " |[[Myocardial infarction]] | | style="background: #DCDCDC; " |[[Myocardial infarction]] | ||
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**[[ST depression]] in several leads plus [[ST elevation]] in lead aVR (suggestive of occlusion of the left main or proximal [[LAD artery]]) | **[[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]]) | **New [[left bundle branch block]] ([[LBBB]]) | ||
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| rowspan="2" style="background: #DCDCDC; " |[[Valvular Diseases|Valvular involvement]] | | rowspan="2" style="background: #DCDCDC; " |[[Valvular Diseases|Valvular involvement]] | ||
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**Enlargement of the terminal negative portion of the [[P wave]] in VI | **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]]) | **[[P wave]] amplitude >2.5 mm in inferior leads (II, III, AVF) or >1.5 mm in V1/V2 ([[P pulmonale]]) | ||
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| style="background: #DCDCDC; " |[[Mitral regurgitation]] | | style="background: #DCDCDC; " |[[Mitral regurgitation]] | ||
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**Strain pattern | **Strain pattern | ||
**Inverted check mark pattern to the [[T wave]] in the lateral leads | **Inverted check mark pattern to the [[T wave]] in the lateral leads | ||
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| rowspan="2" style="background: #DCDCDC; " |[[Arrythmias|Arrhythmias]] | | rowspan="2" style="background: #DCDCDC; " |[[Arrythmias|Arrhythmias]] | ||
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* [[Left anterior fascicular block]] | * [[Left anterior fascicular block]] | ||
* [[Left posterior fascicular block]] | * [[Left posterior fascicular block]] | ||
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|- | |- | ||
| style="background: #DCDCDC; " |[[Supraventricular arrhythmias]] | | style="background: #DCDCDC; " |[[Supraventricular arrhythmias]] | ||
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* [[Atrial fibrillation]] | * [[Atrial fibrillation]] | ||
* [[Atrial flutter]] | * [[Atrial flutter]] | ||
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| rowspan="2" style="background: #DCDCDC; " |[[Pericardial disease]] | | rowspan="2" style="background: #DCDCDC; " |[[Pericardial disease]] | ||
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*Reduced voltage with quasi-specific ST-T waves due to increase in [[scar tissue]], fluid and [[fibrin]] | *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]] | *The [[EKG]] abnormalities vary depending on the stage/severity of the [[pericarditis]] | ||
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| style="background: #DCDCDC; " |[[Pericardial effusion]] | | style="background: #DCDCDC; " |[[Pericardial effusion]] | ||
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* [[Electrical alternans]] | * [[Electrical alternans]] | ||
** An [[Electrocardiogram|electrocardiographic]] phenomenon of alternation of [[QRS complex]] amplitude or [[axis]] between beats | ** An [[Electrocardiogram|electrocardiographic]] phenomenon of alternation of [[QRS complex]] amplitude or [[axis]] between beats | ||
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| colspan="2" style="background: #DCDCDC; " |[[Myocarditis]] | | colspan="2" style="background: #DCDCDC; " |[[Myocarditis]] | ||
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*Low voltage of the [[QRS]] complexes | *Low voltage of the [[QRS]] complexes | ||
*[[Arrhythmias]] such as [[atrial]] or [[ventricular]] ectopic beats, [[atrial]] or [[Ventricular Tachycardia|ventricular tachycardias]], and [[atrial fibrillation]] | *[[Arrhythmias]] such as [[atrial]] or [[ventricular]] ectopic beats, [[atrial]] or [[Ventricular Tachycardia|ventricular tachycardias]], and [[atrial fibrillation]] | ||
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| colspan="2" style="background: #DCDCDC; " |[[Coronary heart disease|Coronary artery disease]] | | colspan="2" style="background: #DCDCDC; " |[[Coronary heart disease|Coronary artery disease]] | ||
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** Exercise induced [[ventricular arrhythmia]] | ** Exercise induced [[ventricular arrhythmia]] | ||
** [[Hemodynamics|Hemodynamic]] changes during the test | ** [[Hemodynamics|Hemodynamic]] changes during the test | ||
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Revision as of 23:36, 22 August 2017
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Systemic lupus erythematosus Microchapters |
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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 |
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| Libman sacks endocarditis | Heart failure | ||
| Myocardial infarction |
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| Valvular involvement | Mitral valve stenosis |
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| Mitral regurgitation |
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| Arrhythmias | AV Blocks | ||
| Supraventricular arrhythmias | |||
| Pericardial disease | Acute pericarditis |
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| Pericardial effusion |
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| Myocarditis |
The ECG findings most commonly seen in myocarditis are:
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| Coronary artery disease |
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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.