Appearance of right bundle branch block in electrocardiograms of patients with pulmonary embolism as a marker for obstruction of the main pulmonary trunk

Petrov, Daniel Bogdanov

doi:10.1054/jelc.2001.25132

Cited by 46 publications

(25 citation statements)

References 5 publications

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“…When there is epicardial STsegment depression, it has been considered to be caused by an injury current flowing in the underlying subendocardium (12). Right precordial ST depression is occasionally observed in inferior myocardial infarction (13) and acute pulmonary thromboembolism (14). In the present case, these ECG changes might be an artifact of cardiac motion, because we observed change in the ECG baseline in each heart beat.…”

Section: Discussionmentioning

confidence: 48%

Chest Pain and ST Segment Depression Caused by Expansion of Gastric Tube Used for Esophageal Reconstruction

et al. 2005

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Section: Discussionmentioning

confidence: 48%

Chest Pain and ST Segment Depression Caused by Expansion of Gastric Tube Used for Esophageal Reconstruction

et al. 2005

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“…59 As reported before {S8}, the many abnormalities observed on clinical examination and routine investigations, particularly in the more severe cases, are of limited value in confirming a diagnosis of PE. [60][61][62][63][64][65][66][67][68][69][70] Even in those with confirmed proximal DVT, respiratory symptoms are a poor predictor of concurrent PE. 71 A new observation is that acute right heart strain in major PE can be detected by the release of cardiac troponin 72-78 due to right ventricular muscle damage 79 80 ; although such measurements may give prognostic information, 77 78 their role in decision making is limited and they are of no diagnostic value in non-massive PE.…”

Section: Clinical Featuresmentioning

confidence: 99%

British Thoracic Society guidelines for the management of suspected acute pulmonary embolism

2003

Thorax

613

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“…In contrast to previous data, it is shown that many of the classically described ECG changes are more prevalent in chronic RV pressure overload states than in patients with acute RV loading states. The relationship between ECG parameters and RV overload is well known (20)(21)(22)(23)(24)(25). In spite of the great scattering of the ECG data, our study indicates that it is impossible to identify patients with pulmonary hypertension whether it is chronic or acute by ECG.…”

Section: Discussionmentioning

confidence: 99%

Role of electrocardiographic changes in discriminating acute or chronic right ventricular pressure overload

Can¹,

Özveren²,

Biteker³

et al. 2013

Anadolu Kardiyol Derg

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Objective: Pulmonary embolism (PE) and severe pulmonary stenosis (PS) are two distinct conditions accompanied by increased pressure load of the right ventricle (RV). Despite major advances in our understanding of the mechanisms of RV adaptation to the increased pressure, substantial gaps in our knowledge remain unsettled. One of much less known aspect of pressure overload of RV is its impact on electrocardiographic (ECG) changes. In this study, we aimed to study whether acute and chronic RV overload are accompanied by different ECG patterns. Methods: Thirty-eight patients with PE underwent ECG monitoring were compared with 20 matched patients with PS in this observational retrospective study. ECG abnormalities suggestive of RV overload were recorded and analyzed in both groups. Logistic regression analysis was used to define the predictors of chronic RV overload. Results: Among the ECG changes studied, premature atrial contraction (OR-12.2, 95% CI, 1.3-107, p=0.008), right axis deviation (OR-20.4, 95% CI 4.2-98, p<0.001), indeterminate axis (OR-0.11, 95% CI 0.02-0.44, p=0.001 0.11), incomplete right bundle branch block (OR-4.2, 95% CI, 1.1-15.4, p=0.02), late R in aVR (OR-8.4, 95% CI 2.1-33.2, p=0.001), qR in V1 lead (OR-8.3, 95% CI 1.2-74.8, p=0.03) were found to be the independent predictors of chronic RV pressure overload. Conclusion: Our data indicate that the ECG changes that attributed to the acute RV pressure loading states may be more prevalent in chronic RV overload as compared with acute RV overload. (Anadolu Kardiyol Derg 2013; 13: 344-9) Key words: Right ventricular pressure load, electrocardiography, disease process, regression analysis Original Investigation Özgün Araşt›rma 344ÖZET Amaç: Sağ ventrikül (SV) fonksiyonu birçok kardiyopulmoner hastalıklarda klinik sonlanım olarak önemli rol oynar. Pulmoner emboli (PE) ve ciddi pulmoner darlık (PD) SV basınç yüklenmesi ile seyreden iki ayrı hastalıktır. SV' nin artmış basınç yüklenmesine karşı verdiği uyum mekanizmaları iyi bilinmesine karşın hala bazı tanımlanmamış boşluklar devam etmektedir. SV basınç yüklenmesinin elektrokardiyografik (EKG) olarak nasıl bir deği-şiklik yaptığı pek bilinmemektedir. Çalışmamızdaki amaç akut ve kronik basınç yüklenmesini EKG olarak ayrımının yapılabileceğini araştırmaktır. Yöntemler: Bu retrospektif gözlemsel çalışmamıza 20 PD ve 38 PE tanısı kesinleşmiş hasta dahil edildi. SV yüklenmesini gösterdiği daha önceki çalışmalarda kabul edilmiş EKG kriterleri her iki grupta araştırıldı. Logistic regression analysis was used to define the predictors of chronic RV overload. Bulgular: Bakılan EKG değişikliklerinden, prematür atriyal atım (OR-12.2, %95 CI, 1.3-107, p=0.008), sağ aks deviasyonu (95)(96)(97)(98) p=0.001), indetermine aks (OR-0.11, %95 CI 0.02-0.44, p=0.001), inkomplet sağ dal bloğu (OR-4.2, %95 CI, 1.1-15.4, p=0.02), aVR de geç R dalgası (OR-8.3, %95 CI 1.2-74.8, OR-8.4, %95 CI 2.1-33.2 p=0.001), V1' de qR dalgası (OR-8.3, %95 CI 1.2-74.8 p=0.02) SV kronik basınç yüklenmesini gös-teren bağımsız prediktörle...

show abstract

Appearance of right bundle branch block in electrocardiograms of patients with pulmonary embolism as a marker for obstruction of the main pulmonary trunk

Cited by 46 publications

References 5 publications

Chest Pain and ST Segment Depression Caused by Expansion of Gastric Tube Used for Esophageal Reconstruction

Chest Pain and ST Segment Depression Caused by Expansion of Gastric Tube Used for Esophageal Reconstruction

British Thoracic Society guidelines for the management of suspected acute pulmonary embolism

Role of electrocardiographic changes in discriminating acute or chronic right ventricular pressure overload

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