The electrocardiogram and cardiac state in active sickle-cell anemia

Winsor, Travis; Burch, George E.

doi:10.1016/s0002-8703(45)90441-8

Cited by 39 publications

(22 citation statements)

References 8 publications

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“…The appearance of LVH in 57% of our patients agrees with the 50% figure given by others (Klinefelter, 1942;Shubin, 1960; Windsor and Burch, 1945). However, 40% of our subjects had first degree A-V block as compared to approximately 10% elsewhere (Klinefelter, 1942;Shubin, 1960; Windsor and Burch, 1945).…”

Section: Discussionsupporting

confidence: 90%

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Continuous electrocardiographic monitoring in patients with sickle‐cell anemia during pain crisis

Maisel

Frıedman

Flint

et al. 1983

Clinical Cardiology

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Summary:Electrocardiographic studies in patients with sickle-cell anemia have been performed during the normal resting state with routine twelve-lead ECGs. We studied 30 patients with sickle-cell disease in acute crisis with 24-hour continuous electrocardiographic monitoring. The standard ECG demonstrated a high incidence of abnormalities, but only three patients had arrhythmias. These findings contrasted sharply with the results of continuous monitoring, during which arrhythmias were detected in 24 of 30 patients. They were fairly evenly split between atrial (60%) and ventricular (67%). Nine of the patients had "complex arrhythmias" including two with episodes of ventricular tachycardia. Seventeen patients subsequently underwent equilibrium gated-blood pool scans. Eight patients had abnormal contractility and tended to have more arrhythmias on monitoring than those with normal contractility. Thus, continuous electrocardiographic monitoring of sickle-cell patients during crisis revealed a higher incidence of arrhythmias than previously thought.

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Section: Discussionsupporting

confidence: 90%

“…Cardiovascular abnormalities have played a prominent part in sickle-cell anemia since the condition was first described by James Herrick in 1910 (Herrick,191 Windsor and Burch, 1945). The appearance of LVH in 57% of our patients agrees with the 50% figure given by others (Klinefelter, 1942;Shubin, 1960; Windsor and Burch, 1945).…”

Section: Discussionsupporting

confidence: 85%

Continuous electrocardiographic monitoring in patients with sickle‐cell anemia during pain crisis

Maisel

Frıedman

Flint

et al. 1983

Clinical Cardiology

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“…However, there were no signs of heart failure observed on physical examination in our pediatric population. Heart murmurs have been commonly reported in patients with SCA, with an incidence of 72-100% [26][27][28]. In this study, the incidence was 87% with the degree of murmur correlating with the severity of anemia.…”

Section: Clinical Findingsmentioning

confidence: 48%

Cardiac abnormalities in children with sickle cell anemia

et al. 2002

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Sickle cell anemia (SCA) results in chronic volume overload of the heart due to hemodilution. Previous echocardiographic studies of cardiac function in children with SCA have not accounted for these abnormal loading conditions. The objectives of this study were to (1) determine how the degree of anemia and transfusion status relate to cardiac findings and (2) evaluate cardiac function using load-independent parameters of function. We evaluated 77 patients with SCA, ages 2 to 22 years (mean ± SD = 11.7 ± 4.7), using physical examination, electrocardiography, and echocardiography. We compared two groups of patients. Group 1 consisted of 57 non-transfused patients, and Group 2 consisted of 20 patients on a chronic transfusion protocol. Group 1 patients exhibited a significantly lower hemoglobin, higher cardiac output, and larger left ventricular (LV) end-diastolic dimension and LV mass than groups 2 (P < 0.05). However, the velocity of circumferential fiber shortening-wall stress index (a load-independent measure of systolic function) was normal and not statistically different between the two groups. Conversely, the LV myocardial performance index (a measure of combined systolic and diastolic function) was significantly higher in Group 2 (P < 0.001), possibly indicating impaired myocardial diastolic function. SCA in children results in a volume-overloaded heart with a significant increase in LV dimensions and mass, both proportional to the degree of anemia. Despite these abnormal loading conditions, systolic function is preserved. Patients on a chronic transfusion protocol may develop diastolic dysfunction despite iron chelation therapy. Am.

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“…It is not certain, however that these changes are more common in anemic patients [1]. The abnormalities may be proportional to the severity of anaemia [10], or show no correlation to Hb level [11]. Hence in the present study we intended to study the electrocardiographic changes in anemic population and to correlate ECG changes seen with increasing severity of anaemia, with respect to every 1gm% decrease in hemoglobin (Hb) level from 8 gm% onwards.…”

Section: Introductionmentioning

confidence: 99%

Correlation Between Haemoglobin Level and Electrocardiographic (ECG) Findings in Anaemia: A Cross-Sectional Study

Herur

et al. 2014

JCDR

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Background: Anaemia affects the body by decreased oxygen (O 2 ) carrying capacity of the blood. There is growing evidence that anaemia contributes to cardiac disease and death. It causes O 2 supply -demand myocardial mismatch causing myocardial ischemia. There is diversity of opinion available in literature on reports of electrocardiographic (ECG) changes in anaemia. Aim:To study the ECG changes in anemic population and to correlate ECG changes seen with increasing severity of anaemia. Materials and Methods:In hundred anemic adults, haemoglobin level and resting ECG were recorded. They were grouped according to haemoglobin level. ECG findings and varying severity of haemoglobin (Hb) level of each group were correlated using Pearson's co-relation co-efficient and association was calculated using Chi-square test.Results: ECG changes in patients with Hb level of 0-5gm% showed ST segment depression in 50-75%, T wave changes in 29-50% and Left Ventricular Hypertrophy (LVH) in 25-30% of patients. Less percentage of patients with 5-7gm% Hb showed such changes, and patients with 7-8gm% Hb, showed no changes.

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The electrocardiogram and cardiac state in active sickle-cell anemia

Cited by 39 publications

References 8 publications

Continuous electrocardiographic monitoring in patients with sickle‐cell anemia during pain crisis

Continuous electrocardiographic monitoring in patients with sickle‐cell anemia during pain crisis

Cardiac abnormalities in children with sickle cell anemia

Correlation Between Haemoglobin Level and Electrocardiographic (ECG) Findings in Anaemia: A Cross-Sectional Study

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