Aortic stenosis electrocardiogram: Difference between revisions
No edit summary |
|||
| Line 1: | Line 1: | ||
__NOTOC__ | |||
{{Aortic stenosis}} | {{Aortic stenosis}} | ||
| Line 54: | Line 55: | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 16:04, 15 August 2012
|
Aortic Stenosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Percutaneous Aortic Balloon Valvotomy (PABV) or Aortic Valvuloplasty |
|
Transcatheter Aortic Valve Replacement (TAVR) |
|
Case Studies |
|
Aortic stenosis electrocardiogram On the Web |
|
American Roentgen Ray Society Images of Aortic stenosis electrocardiogram |
|
Directions to Hospitals Treating Aortic stenosis electrocardiogram |
|
Risk calculators and risk factors for Aortic stenosis electrocardiogram |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Mohammed A. Sbeih, M.D. [2]; Lakshmi Gopalakrishnan, M.B.B.S. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]
Overview
The electrocardiogram in the patient with moderate to severe aortic stenosis may reveal left ventricular hypertrophy and heart block.
Electrocardiogram
- Although there are no specific findings on the EKG, the presence of left ventricular hypertrophy (LVH) secondary to chronic pressure overload of the left ventricle due to aortic stenosis is commonly observed.
- Progressive calcification of the aortic valve may extend beyond the valve and may result in conduction abnormalities of the heart including heart block.
- Progressive concentric hypertrophy of the left ventricular wall may lead to larger QRS complexes, especially observed in leads V1-V6. The S wave in V1 is deep, the R wave in V4 is high. Often some ST depression can be seen in leads V5-V6, which is in this setting is called a left ventricular strain pattern.
EKG Criteria for LVH
- To diagnose left ventricular hypertrophy on the EKG one of the following criteria should be met:
- Sokolow-Lyon criteria:
- R in V5 or V6 + S in V1 >35 mm.
- Other criteria:
- R >26 mm in V5 or V6.
- R >20 mm in I, II or III.
- R >12 mm in aVL (in the absence of left anterior fascicular block).
- Cornell-criteria has different values in men and women:
- R in aVL and S in V3 >28 mm in men
- R in aVL and S in V3 >20 mm in women
- In the Romhilt-Estes Score,[1]
Examples of EKG Findings in patients with AS
Left Ventricular Hypertrophy
Severe LVH in a patient with Severe Aortic Stenosis
Patient with LVH and Subendocardial Ischemia
LVH & Left Ventricular Strain Pattern
References
- ↑ Romhilt DW, Bove KE, Norris RJ, Conyers E, Conradi S, Rowlands DT; et al. (1969). "A critical appraisal of the electrocardiographic criteria for the diagnosis of left ventricular hypertrophy". Circulation. 40 (2): 185–95. PMID 4240354.
- ↑ Romhilt DW, Estes EH (1968). "A point-score system for the ECG diagnosis of left ventricular hypertrophy". Am Heart J. 75 (6): 752–8. PMID 4231231.