- Prognostic Significance of Left Axis Deviation in Acute Heart Failure Patients with Left Bundle branch block: an Analysis from the Korean Acute Heart Failure (KorAHF) Registry. [Journal Article]
- KCKorean Circ J 2018; 48(11):1002-1011
- CONCLUSIONS: Among the AHFS with LBBB patients, LAD did not predict mortality, but it could be used as a significant predictor of worse LVEF and RV dilatation (Trial registry at KorAHF registry, ClinicalTrial.gov, NCT01389843).
- Late Cardiac Complications of Sulfur Mustard Poisoning in 38 Iranian Veterans. [Journal Article]
- CTCardiovasc Toxicol 2018 Sep 21
- It was aimed to investigate possible late cardiac effects of Sulfur mustard (SM) exposure in Iranian veterans. Thirty-eight veterans with late complications of SM exposure were investigated. Clinical...
It was aimed to investigate possible late cardiac effects of Sulfur mustard (SM) exposure in Iranian veterans. Thirty-eight veterans with late complications of SM exposure were investigated. Clinical history, physical examinations, 12 leads electrocardiography and transthoracic echocardiography were performed. Computed tomography coronary angiography (CTCA) was performed as clinically indicated for angiographic assessment and patients were stratified according to the CTCA findings. Incomplete right bundle branch block and right axis deviation were detected in 3 (7.9%) and 4 (10.5%) cases, respectively. Mean value of left ventricular ejection fraction was 55.7 ± 2.9%. Different degrees of right ventricular dilation was observed in seven (18.4%) patients. All the patients showed mild to moderate degrees of tricuspid regurgitation. Increased pulmonary artery pressure (PAP) was detected in 16 (42.1%) patients. Out of 18 patients who underwent CTCA, non-obstructive and obstructive coronary artery disease (CAD) were observed in three (16.66%) and eight (44.44%) patients, respectively. CAD was stratified to single vessel (5.5%), two vessels (27.8%) and three vessels disease (11.1%). Mean coronary artery calcium score was 50.91 ± 115.58. SM has cardiovascular toxicity, as a delayed complication of this chemical warfare poisoning.
- Extreme Right Axis Deviation in Acute Myocardial Infarction: A Hazardous Signal of Poor Prognosis. [Case Reports]
- AJAm J Case Rep 2018 May 11; 19:553-556
- CONCLUSIONS: New diagnosed RBBB and right axis deviation is uncommon and could be a useful clue to evaluate myocardial ischemia in AMI cases. This electrocardiographic marker can identify coronary artery occlusion where ST-segments are hard to evaluate, and hence, patients may benefit most from early and complete revascularization strategies such as primary angioplasty.
- Beyond the length and look of repolarization: Defining the non-QTc electrocardiographic profiles of patients with congenital long QT syndrome. [Journal Article]
- HRHeart Rhythm 2018; 15(9):1413-1419
- CONCLUSIONS: Beyond the QT interval and bradycardia, ECG abnormalities are uncommon in LQTS patients, and patients almost never have concomitant bundle branch block. Notably, 19% of LQTS patients overall and 27% of LQTS type 2 patients exhibit anterior TWI that would satisfy a diagnostic criterion for arrhythmogenic right ventricular cardiomyopathy, thus creating the potential for diagnostic miscues.
- Mild cough · wheezing · loud heart sounds · Dx? [Case Reports]
- JFJ Fam Pract 2018; 67(2):95-98
- A 25-year-old man, who was an active duty US Navy sailor, went to his ship's medical department complaining of a mild cough that he'd had for 2 days. He denied having any fevers, chills, night sweats...
A 25-year-old man, who was an active duty US Navy sailor, went to his ship's medical department complaining of a mild cough that he'd had for 2 days. He denied having any fevers, chills, night sweats, angina, or dyspnea. He said he hadn't experienced any exertional fatigue or difficulty completing the rigorous physical tasks of his occupation as an engineman on the ship. The patient had no medical or surgical history of significance, and he wasn't taking any medications or supplements. On exam, he was not in acute distress and his vital signs were within normal limits. Auscultation revealed mild wheezing throughout the upper lung fields and loud heart sounds throughout his chest that were audible even with gentle contact of the stethoscope diaphragm. He had no discernible murmurs, rubs, or gallops. In light of the unusually loud heart sounds heard on exam, we performed an electrocardiogram. The EKG revealed a normal sinus rhythm, slight right axis deviation indicated by tall R-waves in V1 (also suggestive of right ventricular hypertrophy), an incomplete right bundle branch block, and a crochetage sign (a notch in the R-waves of the inferior leads). A chest x-ray revealed a normal-sized heart and dilated pulmonary vasculature suggestive of pulmonary hypertension.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- One of the key steps in interpreting an electrocardiogram (EKG) is determining the electrical axis of the heart. Being able to determine the electrical axis can give insight into underlying disease s...
One of the key steps in interpreting an electrocardiogram (EKG) is determining the electrical axis of the heart. Being able to determine the electrical axis can give insight into underlying disease states and help steer the differential diagnosis towards or away from certain diagnoses. Herein, we will discuss what makes up the electrical axis, ventricular (QRS) axis, axis classifications, various approaches to determining the electrical axis, and causes of axis deviation.
- [Clinical and electrocardiographic aspect of pulmonary embolism masking aortic dissection revealed by thoracic CT angiography]. [Case Reports]
- PAPan Afr Med J 2017; 28:3
- We here report the case of a 52-year old hypertensive, obese woman (BMI 32,46 kg/m2) with a past history of smoking and without evidence-based risk factors of venous thromboembolism, hospitalized for...
We here report the case of a 52-year old hypertensive, obese woman (BMI 32,46 kg/m2) with a past history of smoking and without evidence-based risk factors of venous thromboembolism, hospitalized for left chest pain radiating to the dorsolumbar region associated with dyspnoea. Clinical examination on hopitalization showed left blood pressure 100/60 mmHg, tachycardia 100/min, oxygen desaturation index at 88% with the patient breathing ambient air, normal cardiopulmonary auscultation, peripheral pulses palpable and no symptoms of phlebitis of the lower limbs. The ECG showed right axis deviation, S1Q3 pattern, right ventricular hypertrophy and right bundle branch block (A, B, C). The patient underwent emergency thoracic CT angiography objectifying aortic dissection from the origin of the aorta to the iliac bifurcation (Stanford A). Our patient received medical care based on blood pressure and heart rate control as well as on analgesics, with good evolution in the absence of surgical means.
- Right ventricular systolic function and mechanical dispersion identify patients with arrhythmogenic right ventricular cardiomyopathy. [Journal Article]
- CPClin Physiol Funct Imaging 2018; 38(5):779-787
- CONCLUSIONS: ARVC patients had lower longitudinal absolute strain amplitude in basal RV segments and increased mechanical dispersion compared to healthy volunteers, but the presence of mechanical dispersion was not predictive of ventricular arrhythmia.
- Prevalence and predictive value of electrocardiographic abnormalities in pulmonary hypertension: evidence from the Pan-African Pulmonary Hypertension Cohort (PAPUCO) study. [Multicenter Study]
- CJCardiovasc J Afr 2017 Nov/Dec 23; 28(6):370-376
- CONCLUSIONS: When present, signs of PH on ECG strongly indicated disease, but a normal ECG cannot rule out disease. ECG patterns focusing on the R and S amplitude in V1 and right-axis deviation had good specificity and negative predictive values for PH, and warrant further investigation with echocardiography.
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- Incidence rates, correlates, and prognosis of electrocardiographic P-wave abnormalities - a nationwide population-based study. [Journal Article]
- JEJ Electrocardiol 2017 Nov - Dec; 50(6):925-932
- CONCLUSIONS: Modifiable risk factors associate with P-wave abnormalities that are common and may represent intermediate steps of atrial cardiomyopathy on a pathway leading to AF.