PR depression with multilead ST elevation and ST depression in aVR by left circumflex artery occlusion: How to differentiate from acute pericarditis

Zhong-qun, Zhan; Nikus, Kjell; Birnbaum, Yochai

doi:10.1111/anec.12752

Cited by 5 publications

(4 citation statements)

References 8 publications

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“… 20 In a few studies, the PR segment was evaluated in acute myocardial infarction (MI) which showed PR segment depression may be seen in circumflex artery occlusion. 21 In addition, this may be used as a predictor of heart block in inferior MI. 22 The PR segment was not evaluated in the patients with PH in the previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…The PR segment has received more attention in pericarditis which present with diffuse PR segment depression 20 . In a few studies, the PR segment was evaluated in acute myocardial infarction (MI) which showed PR segment depression may be seen in circumflex artery occlusion 21 . In addition, this may be used as a predictor of heart block in inferior MI 22 .…”

Section: Discussionmentioning

confidence: 99%

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The prediction of right atrial pressure using electrocardiogram: a novel approach

et al. 2021

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Aims Pulmonary hypertension (PH) is a serious disorder that can complicate pulmonary and cardiovascular diseases. Right atrial (RA) pressure is a robust predictor of the pulmonary hypertension severity, which is measured via right heart catheterization. Limited studies have been carried out to assess the association between electrocardiogram data and the RA pressure as a prognostic factor of PH. In this study, the relation between P wave and PR segment changes with RA pressure was evaluated. Methods and results In this study, 94 patients in PH groups of 1, 3, and 4, based on the World Health Organization classification, were entered. RA pressure was measured using the right heart catheterization. PR segment and P wave morphology in leads II and V1 were evaluated in patient's electrocardiogram. The median age of the patients was 35.5 years old in which 64.9% of them were female. The distribution of patients in groups 1, 3, and 4 PH were 77.7%, 5.3%, and 17%, respectively. Among the studied P wave and PR segment changes, PR segment depression in lead II and pulmonary P wave in lead V1 had significant relation with the RA pressure (P‐value <0.001). The sensitivity, specificity, and negative predictive values of PR segment depression for detection of patients with high RA pressure (RA pressure > 14 mmHg) were 80%, 84%, and 94%. The specificity and negative predictive values of pulmonary P wave in lead V1 were determined 89% and 88%. Conclusions It was found that the PR segment depression in lead II and pulmonary P wave in lead V1 associate with the RA pressure in patients with precapillary PH. PR segment depression had useful sensitivity, specificity, and negative predictive values, and the pulmonary P wave in lead V1 had acceptable specificity and negative predictive values for detection of patients with high RA pressure. Therefore, the electrocardiogram can be used as a screening tool for determination of pulmonary hypertension severity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The prediction of right atrial pressure using electrocardiogram: a novel approach

et al. 2021

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“…signs of acute pericarditis are P.R.-segment distress (found rarely), multi-lead S.T. segment rise, and S.T.-segment distress in the lead named aVR [ 29 ].…”

Section: Reviewmentioning

confidence: 99%

Importance of ECG in the Diagnosis of Acute Pericarditis and Myocardial Infarction: A Review Article

Sarda¹,

Thute²

2022

Cureus

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A promising scientific field is health monitoring and associated technology. A standard testing method to evaluate and identify heart issues is the electrocardiogram (E.C.G.) and diagnose cardiovascular diseases (CVDs). E.C.G. monitoring technologies are becoming more and more prevalent in publications at an exponential rate. E.C.G. is the most crucial tool for screening cardiology and other medical specialities. Twelve leads can be recorded by traditional E.C.G. equipment, while current E.C.G. systems allow for extra leads also with fewer electrodes. Furthermore, "smart" gadgets allow patients to take an E.C.G. at residence. Presenting different ischemia-related symptoms on the E.C.G. by the most recent recommendations. Presentation of contemporary E.C.G. systems and their possible benefit in identifying ischemia-related E.C.G. symptoms based on recent study findings. The identification of ischemia E.C.G. abnormalities can be facilitated and optimised by current E.C.G. systems using vector-based electrocardiography. Although they can be effective for documenting transient E.C.G. abnormalities, especially inside the S.T. segment, smart non-vector-based devices for patients are primarily beneficial for the diagnosis of arrhythmias and cannot substitute the 12-lead E.C.G. for the diagnosis of ischemia. The electrocardiogram (E.C.G.) is inexpensive and easily accessible, but because of its alleged limited specificity, its utility as a screening tool for early detection of athletes with a cardiac condition in danger of immediate cardiac death is contentious. The interpreting parameters have been continuously evolving over the past 10 years as various efforts have been made to better the separation between healthy and pathological E.C.G. abnormalities in athletes. Electrocardiographic abnormalities that are unrelated to cardiac electrical activity are known as electrocardiographic artefacts. E.C.G. elements, including the baseline and waves, can become altered as a result of artefacts.

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“…• In STEMI, depression of the PR segment in the inferior wall is a prognostic criterion (≥1.2 mm) associated with atrioventricular block, supraventricular arrhythmias, and rupture of the free wall with a consequent increase in mortality in 1 year 19,20 .…”

Section: Atrial Infarctionmentioning

confidence: 99%

The Electrocardiogram in the Differential Diagnosis of Cardiologic Conditions Related to the COVID-19 Pandemic

Predabon

Souza

Bertoldi

et al. 2020

J Cardiac Arrhtythmias

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The World Health Organization (WHO) declared Sars-CoV infection and COVID-19 as a pandemic and global emergency. In addition to viral pneumonia and the severe acute respiratory syndrome (Sars), the heart is affected in some patients due to the detection of biomarkers and reported cases of myocarditis and pericarditis. Therefore, the knowledge of electrocardiogram presentation of these actual infections can guide the choice for the best treatment and can help to reduce misdiagnosis, mainly the acute myocardial infarction, which is the main differential diagnosis.

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PR depression with multilead ST elevation and ST depression in aVR by left circumflex artery occlusion: How to differentiate from acute pericarditis

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 5 publications

References 8 publications

The prediction of right atrial pressure using electrocardiogram: a novel approach

The prediction of right atrial pressure using electrocardiogram: a novel approach

Importance of ECG in the Diagnosis of Acute Pericarditis and Myocardial Infarction: A Review Article

The Electrocardiogram in the Differential Diagnosis of Cardiologic Conditions Related to the COVID-19 Pandemic

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