Congestive heart failure electrocardiogram
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 often shows low 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 hear failure includes:
- Poor R wave progression: in the precordial leads may be secondary to a prior myocardial infarction but can be observed in the absence of a prior myocardial infarction.
- 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.