ABC of clinical electrocardiography: Conditions affecting the left side of the heart

Edhouse, June

doi:10.1136/bmj.324.7348.1264

Cited by 29 publications

(22 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Current or past use of oral contraceptives was recorded as informed by patient. The presence of end-organ damage was defined as creatinine level higher than 1.2 mg per 100 ml; left ventricular hypertrophy recorded on electrocardiogram (defined as R in leads V5 or 6 plus S-wave in lead V1X35 mm in a direct analysis) 12 or by colour Doppler echocardiogram, and diagnoses of optic fundi abnormality by direct fundoscopy (arteriolar narrowing, abnormal arteriovenous crossing, retinal haemorrhages or exudates).…”

Section: Methodsmentioning

confidence: 99%

Association between pregnancy-related hypertension and severity of hypertension

et al. 2008

View full text Add to dashboard Cite

Hypertension in pregnancy is an emerging sex-specific risk factor for cardiovascular disease and may lead to more severe hypertension after pregnancy. The objectives of this study were to investigate the frequency of pregnancy-related hypertension among patients referred to a hypertension clinic and its association with the severity of hypertension and evidence of end-organ damage. In this cross-sectional study, women with hypertension were submitted to a systematic clinical evaluation. The occurrence of pregnancy-related hypertension was investigated by questionnaire. The association between pregnancy-related hypertension and severity of hypertension (stage 2 according to Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII)) and end-organ damage was assessed in a logistic regression model. The mean age, systolic and diastolic blood pressure and body mass index (BMI) of the 768 women examined were 51.6 ± 12.7 years, 158.2 ± 26.6 mm Hg, 93.8 ± 14.3 mm Hg and 29.4±5.6 kg/m 2 , respectively. The proportion of women with pregnancy-related hypertension was 32.9%. It was significantly associated with hypertension at stage 2 (OR: 1.60, 95% CI: 1.14-2.24; P ¼ 0.01) after controlling for confounders. The occurrence of a pregnancy-related hypertension was not associated with evidence of optic fundi abnormalities, left ventricular hypertrophy or abnormalities in kidney function. In conclusion, pregnancy-related hypertension is frequent in women referred to a hypertension clinic, and is associated with severe hypertension but not with evidence of end-organ damage.

show abstract

Section: Methodsmentioning

confidence: 99%

Association between pregnancy-related hypertension and severity of hypertension

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Findings such as right or left axis deviation, right or left bundle branch block (RBBB or LBBB), ST-T changes, early repolarisation, premature ventricular contractions, premature atrial contractions, atrial fi brillation, right or left atrial enlargement, right or left ventricular strain pattern, and ventricular dysrhythmias including type were also recorded according to procedures described elsewhere (31,32). Interpretation of the ECGs was supervised by two cardiologists blind to the topic of the study.…”

Section: Methodsmentioning

confidence: 99%

Electrocardiographic Manifestations in Acute Methanol Poisoning Cannot Predict Mortality

Sanaei‐Zadeh

Emamhadi

Farajidana³

et al. 2013

Archives of Industrial Hygiene and Toxicology

View full text Add to dashboard Cite

The aim of this retrospective observational case series was to determine electrocardiographic (ECG) manifestations in patients poisoned with methanol and see whether they could predict mortality. We also wanted to see whether there was an association between ECG changes and time elapsed between ingestion and treatment, age, sex, seizure, coma (Glasgow Coma Scale ≤8), arterial blood gas (ABG) parameters, and serum potassium levels on hospital admission. The study included 42 patients aged 31.14±12.5 years. Twenty-fi ve survived and 17 died. Almost all patients had one or more abnormal ECG fi ndings, including heart rate, rhythm, and conduction abnormalities. However, we found no signifi cant difference between survivors and non-survivors. QTc interval did not correlate with time elapsed between ingestion and treatment, age, sex, seizure and coma, HCO 3 -, or serum potassium level. Similarly, T waves showed no correlation with serum potassium. ECG abnormalities did not correlate with coma or seizure. Even though cardiotoxicity in methanol poisoning is high, none of the ECG abnormalities found in our study predicted mortality. This however does not rule out the need to routinely run ECG for cardiotoxicity in every single patient poisoned by methanol. Sanaei-Zadeh H, et al. ECG AS MORTALITY PREDICTOR IN METHANOL POISONING Arh Hig Rada Toksikol 2013;64:265-271 Formate is a toxic metabolite of methanol that causes acidosis and inhibits cell cytochromes (1-3). The clinical picture of acute methanol poisoning includes gastrointestinal, visual, and nervous system signs and symptoms such as headache, dizziness, nausea, vomiting, abdominal pain, visual disturbances, coma, respiratory arrest, seizure, blindness, gastrointestinal haemorrhage, putaminal haemorrhage and infarction, and pancreatitis (1,(4)(5)(6)(7)(8)(9)(10)(11)(12). Diagnosis is based on these clinical signs and symptoms, acidbase status, direct serum methanol levels and/or serum formate, and anion and osmolal gaps (4). Clinical guidelines for methanol poisoning management recommend using an antidote (ethanol or fomepizole), intravenous (IV) sodium bicarbonate, folic or folinic acid, and often haemodialysis (1, 2, 13). This poisoning can be intentional and unintentional, isolated and epidemic (7,11,12,(14)(15)(16)(17) (12,(18)(19)(20). To date, several studies have been performed to identify the prognostic factors of mortality in methanol poisoning (5, 7, 11, 14-16, 18, 20, 21). To the best of our knowledge, no literature has considered electrocardiographic (ECG) abnormalities as potential mortality predictors. Articles that do report ECG changes in patients poisoned with methanol are inconsistent (7,(22)(23)(24)(25)(26). In addition, little is known about the relationship between ECG parameters and metabolic/electrolyte disturbances as well as the signs and symptoms of methanol poisoning. KEY WORDS: death, ECG, electrocardiogram, intoxication, methanolOur aim was therefore to see if patients who had died from methanol poisoning differed in ECG parameters ...

show abstract

“…In spite of considerable advances in imaging and diagnostic methods in cardiology, ECG has still maintained its crucial role in the diagnosis of variant problems and pathologies; moreover, it would be so helpful in guiding rapid and appropriate therapies in the field of cardiology and internal medicine [1][2][3][4]. Accordingly, performance of correct and standard ECG is an inevitable need for each health system; missing the probable errors in ECG and inability to correct them may lead to unfavorable outcomes including misdiagnosis and inappropriate treatment [4][5][6][7]. This pilot study was conducted to evaluate the familiarity of ECG operators with essential points of ECG-performance.…”

mentioning

confidence: 99%

Is It Time to Review our Educational Program for the Electrocardiography Operators?

Saadat

Tajdini

Saadat

et al. 2017

ijcp

View full text Add to dashboard Cite

Electrocardiography (ECG) is one of the imperative diagnostic tools in cardiology. In spite of considerable advances in imaging and diagnostic methods in cardiology, ECG has still maintained its crucial role in the diagnosis of variant problems and pathologies; moreover, it would be so helpful in guiding rapid and appropriate therapies in the field of cardiology and internal medicine [1][2][3][4]. Accordingly, performance of correct and standard ECG is an inevitable need for each health system; missing the probable errors in ECG and inability to correct them may lead to unfavorable outcomes including misdiagnosis and inappropriate treatment [4][5][6][7]. This pilot study was conducted to evaluate the familiarity of ECG operators with essential points of ECG-performance. In the current pilot study, ECG operators were interviewed by an educated student. All of the questions were similar to each operator and they were asked subjective questions, together with objective ones. The questions were asked according to a standard questionnaire. A student of biomedical sciences was well-educated to ask questions, without any possible guiding clues. This descriptive pilot study was conducted from June 2016 to November 2016. In this study, 150 ECG operators including 103 females (68.7%) and 47 males (31.3%) were interviewed. The mean age of them was 30.8±10.5 years. Also, 55(36.7%), 21(14%), 67(44.7%), 6(4%) and 1(0.7%) of them had high school diploma, Associate, Bachelor, Master and PHD degrees, respectively. Only 47.3% of them plugged off the ECG device when they performed a standard ECG. Plugging off the device during ECG-performance perhaps seems to be a simple and trivial issue; however, more than half of the ECG-operators performed ECG while the device was plugged in, that may lead to some disturbance, including noises and misinterpretation.On the other hand, 72.7% of them plugged in the ECG device at the end of the usage of the ECG-device; once, they were asked to show speed and voltage buttons, 74.7% and 72% of them made true answers. As objective questions, ECG with changed speed and voltage was presented to them to recognize the speed or voltage errors; only 47.3% and 46% of them recognize the speed and voltage errors, respectively. In this study, 65.3% of the subjects controlled and checked the set-up of the ECG device including speed and voltage before performing ECG and 4% at the beginning of working shift; however, about 30.7% did not check the ECG device in view of speed and voltage set-up. Also, 96.7% and 89.3% of the ECG operators defined correct places of the limb and chest leads, respectively. When they were asked to perform a classic left sided-ECG, 96.7% and 96% of them showed correct performance of installation of limb and chest leads, respectively. When they were asked to perform right sided-ECG, 71.3% showed true performance. The true performance was lower when they were asked to perform posterior sided-ECG, in which, only 49.3% revealed true performance. Once, they were asked to perform Lewis-ECG lea...

show abstract

ABC of clinical electrocardiography: Conditions affecting the left side of the heart

Cited by 29 publications

References 0 publications

Association between pregnancy-related hypertension and severity of hypertension

Association between pregnancy-related hypertension and severity of hypertension

Electrocardiographic Manifestations in Acute Methanol Poisoning Cannot Predict Mortality

Is It Time to Review our Educational Program for the Electrocardiography Operators?

Contact Info

Product

Resources

About