Electrocardiogram in Pneumonia

QRS voltage is a predictor of in‐hospital mortality of acutely ill medical patients

“…Many of our patients had pneumonia and sepsis: changes in QRS voltage have been reported in sepsis and, although not noted by the authors, changes in lead I and II amplitude during the course of pneumonia can be clearly seen in the ECGs displayed in two published reports of ECG changes in pneumonia . Sepsis mortality in the developed world has steadily declined, possibly as a result of protocols that promote resuscitation with intravenous fluids .…”

“…In-hospital mortality QTc >450 ms Lead I + II <1.8 mV Many of our patients had pneumonia and sepsis 23 : changes in QRS voltage have been reported in sepsis 24 and, although not noted by the authors, changes in lead I and II amplitude during the course of pneumonia can be clearly seen in the ECGs displayed in two published reports of ECG changes in pneumonia. 25,26 Sepsis mortality in the developed world has steadily declined, 27 possibly as a result of protocols that promote resuscitation with intravenous fluids. 28,29 However, trials of fluid resuscitation in resource-limited environments have given conflicting results 30 : a possible explanation may be that a reliable and practical method of assessing fluid status is not available in these settings, so that some patients may have been overloaded and others under-loaded with fluid.…”

Electrocardiograhic characteristics in patients with coronavirus infection: A single‐center observational study

“…Although we did not re‐examine the ECG for all the patients because of minimizing exposure of healthcare workers, ECG changes were observed in more than 60% of patients (17/27). New or worsening ECG abnormalities in patients with pneumonia often indicated the degree of cardiac involvement (Corrales‐Medina et al, 2013; Stein et al., 2012). Hui et al (Hui et al, 2020) reported two critically ill patients with COVID‐19 developed new AF during hospitalization and eventually died.…”

Triggering of acute myocardial infarction by respiratory infection

“…In patients with community‐acquired pneumonia, Cangemi and colleagues detected Troponin T elevations in 52% of subjects, whereas only 11% were subsequently diagnosed with MI . In one study of patients with recent pneumonia without a history of CVD, abnormal QRS morphology was seen in 39%, and non‐specific ST segment and T wave abnormalities in 21% of patients . These data indicate that relying on ECG and troponin data to diagnose accurately MI in patients with respiratory infection may lead to misclassification of patients and exposures.…”

“…However, much of the research linking respiratory infection to MI has been conducted using general practice records or regional registries without angiographic confirmation of MI . The absence of angiographic data is an important limitation because elevated troponin and electrocardiogram (ECG) changes may occur in the setting of respiratory infection and myocarditis without MI …”