scholarly journals Electrocardiographic Changes during Normal Pregnancy

2017 ◽  
Vol 02 (03) ◽  
pp. 035-038
Author(s):  
Beeram Sumalatha ◽  
Maddury Jyotsna ◽  
Garre Indrani

Background Pregnancy is a physiologic condition which is unique in that it alters the physiology of each organ in the body. Cardiovascular changes during pregnancy are significant and start at 6 to 8 weeks of gestation. Physiologic cardiovascular changes during pregnancy suggest the chance of altered electrocardiographic (ECG) parameters during pregnancy. Study of variations in ECG in normal pregnant women serves as a basis to detect pathologic changes in pregnant women. Material and Methods This is a cross-sectional data of case series of pregnant women across all stages of gestation who attended antenatal clinic of our teaching hospital, on Women's Day (March 8, 2017). A 12-lead ECG was recorded in all the participants in supine position. The parameters noted from the ECG include heart rate, PR interval, QRS duration, QRS axis, corrected QT (QTc) interval, and ST-T changes. Results Total 151 pregnant women were studied. The average age was 23.38 ± 3.49 years. With respect to gestational age, 12 (7.94%), 48 (31.78%), and 91 (60.26%) women were in the first, second, and third trimesters of pregnancy, respectively. With respect to parity, 60 (39.7%) were primigravidae and 91 (60.26%) were multigravidae. The mean ECG heart rate was increased (100.15 ± 12.48 beats/min). The mean systolic blood pressure (109.67 ± 9.34 mm Hg) and the mean diastolic blood pressure (71.32 ± 6.89 mm Hg) were decreased. The mean of ECG intervals and durations (PR, QRS, QTc) were in normal range (0.14 ± 0.01, 0.08 ± 0.008, and 407.83 ± 11.98, respectively). There was no abnormal P-wave dispersion. Even though the QTc was in normal range in 63.56% of pregnant women, this parameter was in upper quadrant of the normal range. General linear regression demonstrated that systolic blood pressure and palpitations were the only variables to independently predict QTc in upper quadrant of normal range (p = 0.05, 0.03, respectively). Conclusion The cardiovascular hemodynamic adaptation to pregnancy is a well-established fact that is also seen in our study. There is shortening of PR interval and QRS duration. Even though QTc is with in normal range, in more than half (63.56%) of pregnant women, it is in the upper quadrant of the normal range.

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Orchard ◽  
JW Orchard ◽  
H Raju ◽  
A La Gerche ◽  
R Puranik ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JO is supported by an Australian Government Research Training Program scholarship. CS is the recipient of a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (#1154992). Background Athletes sometimes experience transient arrhythmias during intense exercise, which may be difficult to capture with traditional monitors. New highly portable technology, such as smartphone electrocardiogram (ECG) devices, may be useful in documenting and diagnosing exercise-induced arrhythmias. Accuracy of the Kardia single-lead ECG (1L) has been documented, but little data exists for the 6-lead device (6L). Purpose To examine the level of similarity between resting 6L and 12L readings to build evidence for the utility of the 6L as a practical diagnostic tool in athletes. Methods Participants (n = 30 healthy athletes, mean age 18.9 years, 57% male) had a resting supine 12-lead ECG (12L) as part of cardiac screening required by their sport. Within 1 hour, a 30 second 6L reading (leads I, II, III, aVR, aVL, aVF) was taken whilst seated. Data were analysed by 4 expert cardiologists. Manual measurements were taken for PR, QT and RR intervals and QRS duration using EPS digital calipers. To calculate mean 6L RR interval and QT prior to QTc, <10 sequential RR/QT measurements were taken from the middle 10 seconds. QTc was calculated using Bazett’s formula. ECGs were reviewed for rhythm and presence of atrial/ventricular ectopics. Continuous variables were expressed as the mean of 4 cardiologists’ values ± standard deviation. Two-tailed paired t-tests were used to compare continuous variables (p < 0.05 significant). Bland-Altman plots were used to assess quantitative agreement between QRS axis and mean values for QTc interval, QRS duration and PR interval for paired 6L and 12L ECGs. Results There were relatively high levels of agreement between the mean 6L and 12L measures for QTc and PR interval and QRS duration, with the 6L readings slightly but significantly shorter on average. The largest difference was seen in the QTc intervals (391ms vs 401ms, p = 0.003). The 6L QRS durations were shorter on average by 3ms (89ms vs 92ms, p = 0.025) and PR intervals were shorter on average by 6ms (163ms vs 169ms, p < 0.001). There was complete agreement for all cardiologists for sinus rhythm and the presence of ectopics for the 6L and 12L readings. Conclusions The 6L readings had relatively high agreement with the 12L. All 6L measures (except heart rate) were slightly shorter on average than 12L. These small differences are unlikely to have any clinical significance, and are similar to findings comparing the 1L to 12L. 6L heart rates were slightly higher, which is best explained by seated compared to lying position. The reading with the greatest variation was QT interval, some of which is explained by heart rate variation. These pilot data suggest the 6L is sufficiently accurate to be useful in an athletic population as an event monitor for exercise-induced arrhythmias. This may provide more useful diagnostic data than the 1L. Larger studies showing higher levels of agreement with 12L would be required to expand the role of 6L beyond an event monitor. Abstract Figure 1: 6L device, Bland-Altman plots


Author(s):  
Metta Anil Kumar ◽  
J. Muralikrishna ◽  
Anand Acharya

Background: Hypertension is the commonest cardiovascular disorder posing a challenge to the societies in socioeconomic and epidemiologic transition. In India, Cardiovascular Diseases (CVDs) are estimated to be responsible for 1.5 million deaths annually. Indeed, it is estimated that by 2020, CVDs will be the largest cause of mortality and morbidity in India. To present study is designed to evaluate the variation of blood pressure and ECG wave forms among people hypertension with co morbidities (study group) and controls.Methods: The study included 50 people comorbidities with hypertension and 50 controls, each between ages 30-40 years from general population, and also from Medicine outpatient department, KIMS and RF Amalapuram. Detailed history from subjects, blood pressure (sitting position) and electrocardiogram was recorded during resting state in supine position. The ECG results were evaluated for various parameters like heart rate, P wave, PR interval, QRS complex etc.Results: There was significant increase in heart rate, systolic blood pressure as well as diastolic blood pressure in study group when compared to controls. Decrease in PR interval, decrease in QT interval, decrease in QTc interval, decrease in QRS axis in smokers when compared to controls.Conclusions: There was significant increase in heart rate in study group (smokers, diabetic) when compared to controls. There was significant increase in systolic blood pressure as well as diastolic blood pressure in study group (smokers, diabetics) when compared to controls. There was significant decrease in PR interval in smokers when compared to controls. There was significant decrease in QT and QTc interval in smokers when compared to controls.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Sachin A Shah ◽  
Tinh An (April) Nguyen ◽  
Andrew Occiano ◽  
Amanda Chan ◽  
Joseph C Sky ◽  
...  

Introduction: Energy drink usage has been linked to emergency room visits and deaths. Cardiovascular and neurological adverse effects are among the most frequently reported, warranting further exploration of risk factors and cardiovascular outcomes. Hypothesis: We assessed the hypothesis that energy drinks and panax ginseng may contribute to significant electrocardiographic and blood pressure changes in healthy individuals. Methods: This was a randomized, double blinded, placebo controlled, crossover study where young healthy volunteers consumed 3 different study drinks on different days. The interventions included 32 ounces of an energy drink, control drink with 800 mg of panax ginseng or a matching placebo drink, all of which were consumed over a 45 minute period. Primary endpoints of interest were QTc interval and systolic blood pressure. Secondary endpoints included QT interval, PR interval, QRS duration, heart rate, and diastolic blood pressure. All endpoints were assessed at baseline, 1, 2, 3.5, and 5.5 hours post-study drink administration. Results: Twenty seven volunteers completed the study. A significant increase in QTc interval 2 hours post energy drink consumption was evident when compared to placebo (3.37±10.7 msec and -3.19±11.8 msec respectively; p=0.030). Similarly, systolic blood pressure 2 hours post energy drink consumption increased when compared to placebo (2.00±6.37 mmHg and -2.67±5.83 mmHg respectively; p=0.014). The PR interval significantly reduced over a 2 hour period post energy drink use in a clinically non-meaningful manner. Heart rate at 2 hours was not significantly higher in the energy drink group. The QT interval, QRS interval and diastolic blood pressure were not impacted at any time across groups. Conclusions: In conclusion, certain energy drinks consumed at a high volume can significantly increase the QTc interval and systolic blood pressure by over 6 msec and 4 mmHg respectively. Panax ginseng does not have a significant impact on ECG or blood pressure parameters. Future studies are warranted to delineate the electrophysiological and hemodynamic risks of certain energy drinks consumed at different concentrations and durations.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 914.2-914
Author(s):  
S. Boussaid ◽  
M. Ben Majdouba ◽  
S. Jriri ◽  
M. Abbes ◽  
S. Jammali ◽  
...  

Background:Music therapy is based on ancient cross-cultural beliefs that music can have a “healing” effect on mind and body. Research determined that listening to music can increase comfort and relaxation, relieve pain, lower distress, reduce anxiety, improve positive emotions and mood, and decrease psychological symptoms. Music therapy has been used greatly in various medical procedures to reduce associated anxiety and pain. Patients have a high level of anxiety when they are in the hospital, this is the case of patients with rheumatic diseases who consult regularly to have intravenous infusion of biological therapies.Objectives:The purpose of this study was to examine the effectiveness of music therapy on pain, anxiety, and vital signs among patients with chronic inflammatory rheumatic diseases during intravenous infusion of biological drugs.Methods:Fifty patients were divided into two groups: The experimental group G1 (n=25) received drug infusion while lestening to soft music (30 minutes); and the control group G2 (n=25) received only drug infusion. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate). The pain was measured using visual analogic scale (VAS). The state-trait anxiety inventory (STAI) was used for measuring anxiety, low anxiety ranges from 20 to 39, the moderate anxiety ranges from 40 to 59, and high anxiety ranges from 60 to 80. Vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], and respiratory rate [RR]) were measured before, during and immediately after the infusion.Statistical package for social sciences (SPSS) was used for analysis.Results:The mean age in G1 was 44.45 years (26-72) with a sex ratio (M/F) of 0.8. Including the 25 patients, 12 had rheumatoid arthritis, 10 had ankylosing spondylitis and 3 had psoriatic arthritis. The mean disease duration was 8 years. In G2, the mean age was 46 years (25-70) with a sex ratio (M/F) of 0.75, 12 had rheumatoid arthritis, 11 had ankylosing spondylitis and 2 had psoriatic arthritis. The mean disease duration was 7.5 years. The biological drugs used were: Infliximab in 30 cases, Tocilizumab in 12 cases and Rituximab in 8 cases.Before the infusion, the patients of experimental group had a mean VAS of 5/10±3, a mean STAI of 50.62±6.01, a mean SBP of 13.6 cmHg±1.4, a mean DBP of 8.6 cmHg±1, a mean HR of 85±10 and a mean RR of 18±3. While in control group the mean VAS was 5.5±2, the mean STAI was 50.89±5.5, the mean SBP was 13.4±1.2, the mean DBP was 8.8±1.1, the mean HR was 82±8 and the mean RR was 19±2.During the infusion and after music intervention in G1, the mean STAI became 38.35±5 in G1 versus 46.7±5.2 in G2 (p value=0.022), the mean SBP became 12.1±0.5 in G1 versus 13±1 in G2 (p=0.035), the mean DBP became 8.1±0.8 in G1 versus 8.4±0.9 in G2 (p=0.4), the mean HR became 76±9 in G1 versus 78±7 in G2 (p=0.04) and the mean RR became 17.3±2.1 in G1 versus 18.2±1.7 in G2 (p=0.39).This study found a statistically significant decrease in anxiety, systolic blood pressure and heart rate in patients receiving music interventions during biological therapies infusion, but no significant difference were identified in diastolic blood pressure and respiratory rate.Conclusion:The findings provide further evidence to support the use of music therapy to reduce anxiety, and lower systolic blood pressure and heart rate in patients with rheumatic disease during biological therapies infusion.References:[1] Lin, C., Hwang, S., Jiang, P., & Hsiung, N. (2019).Effect of Music Therapy on Pain After Orthopedic Surgery -A Systematic review and Meta-Analysis. Pain Practice.Disclosure of Interests:None declared


2017 ◽  
Vol 3 (6) ◽  
pp. 750-756
Author(s):  
Sri Maisi ◽  
Suryono Suryono ◽  
Melyana Nurul Widyawati ◽  
Ari Suwondo ◽  
Suryati Kusworowulan

Background: Hypertension during pregnancy remains high in Indonesia. It is a major cause of maternal death. Aromatherapy lavender and classical music therapy are considered effective in lowering blood pressure in hypertension.Objective: To examine the effect of lavender aromatherapy and classical music therapy in lowering blood pressure in pregnant women with hypertension.Methods: A quasy experimental study with pretest-posttest control group design. There were 52 pregnant women with the inclusion criteria selected as samples using simple random sampling, divided into lavender aromatherapy group, classical music group, combination of aromatherapy and music group, and control group. Sphygmomanometer was used to measure blood pressure. Mann Whitney and Post Hoc test were used for data analysis.Results: Results showed that four groups have a significant decrease in systolic blood pressure after given intervention with p-value <0.05. The mean decrease of systolic blood pressure among four groups was: lavender group (5.77 mmHg), music group (7.23 mmHg), combination group (9.54 mmHg), and control group (3.67 mmHg); and the mean decrease of diastolic blood pressure was: the lavender group (2.77 mmHg), music group (0.61 mmHg), combination group (8.23 mmHg), and control group (3.42 mmHg).Conclusion: there was a significant effect of lavender aromatherapy and classical music therapy in lowering blood pressure in pregnant women with hypertension. However, the combination of both interventions was more effective than lavender aromatherapy or music therapy alone.


2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Taghi Amiriani ◽  
Vahid Khori ◽  
Ali Davarian ◽  
Niloofar Rajabli ◽  
Mahsa Niknam ◽  
...  

Background: Cirrhosis could lead to a long corrected QT (QTc) interval in a subgroup of patients, but there are spare data on its diurnal variation. Objectives: The present study aimed to determine the diurnal variation of QTc interval and its relationship to heart rate and blood pressure variation during 24-hour Holter-monitoring in non-alcoholic cirrhosis in comparison with the healthy controls. Methods: The study population comprised 15 patients with non-alcoholic cirrhosis and 15 healthy subjects, undergoing 24-hour electrocardiogram (ECG), heart rate, and blood pressure monitoring. The mean QT interval, mean QTc, maximum and minimum QT, QT dispersion (QT disp), heart rate, and mean arterial blood pressure were measured for each person for 24 hours. Liver stiffness measurement (LSM) was performed by FibroScan® 502 machine (EchoSense, Paris, France, 5 MHz). The results were demonstrated as percentages and mean ± SD. P value ≤ 0.05 was considered significant. Results: Mean QTc was significantly higher in cirrhosis (438 ms) than healthy controls (401.7 ms) (P = 0.03). The mean heart rate was significantly different in cirrhotic patients (79.6 ± 2.9/bpm) compared to healthy controls (72.47 ± 2.0/bpm) (P = 0.05). Conclusions: In this study, QTc was prolonged and increased with the severity of cirrhosis, and its diurnal variation in cirrhosis was different from healthy subjects.


1979 ◽  
Vol 57 (s5) ◽  
pp. 393s-396s ◽  
Author(s):  
L. A. Salako ◽  
A. O. Falase ◽  
A. Fadeke Aderounmu

1. The β-adrenoreceptor-blocking effects of pindolol were compared with those of propranolol and a placebo in a double-blind cross-over trial involving nine hypertensive African patients. 2. Heart rate, systolic blood pressure and diastolic blood pressure were measured at rest and immediately after exercise before and at intervals up to 6 h after oral administration of the drugs. In addition, plasma pindolol and propranolol concentrations were determined at the same intervals. 3. Pindolol diminished systolic blood pressure at rest and after exercise and antagonized exercise-induced tachycardia, but had no effect on resting heart rate. Propranolol diminished systolic blood pressure predominantly after exercise and reduced both resting and exercise heart rate. Both drugs had no effect on diastolic pressure. 4. The mean plasma concentration reached a peak at 2 h for each drug and this coincided with the interval at which maximal β-adrenoreceptor-blocking effect was observed.


2021 ◽  
Vol 71 (6) ◽  
pp. 2078-81
Author(s):  
Hina Iftikhar ◽  
Aneel Aslam ◽  
Habib Ur Rehman ◽  
Zulfiqar Ali ◽  
Mohammad Ali Abbass ◽  
...  

Objective: To compare the effect of 0.5% and 0.75% hyperbaric Bupivacaine on haemodynamic stability in terms of mean systolic blood pressure and heart rate recorded at 4 min in patients undergoing caesarian section in spinal anesthesia. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Malir, from Jul to Dec 2018. Methodology: The patients were assigned in two groups (A and B) using lottery method. Group A received 0.5% hyperbaric Bupivacaine solution. Group B received 0.5% hyperbaric Bupivacaine solution. Spinal anaesthesia was given, blood pressure and heart rate were recorded. Data were analyzed in SPSS version 23. Both groups were compared for mean systolic blood pressure and heart rate by using independent sample t-test. Results: The mean age of patients was 29.62 ± 6.21 years in 0.75% Bupivacaine group while 29.31 ± 6.20 years in 0.5% Bupivacaine group. The mean systolic blood pressure of patients was 111.63 ± 5.96 mmHg in 0.75% Bupivacaine group while 117.16 ± 7.12 mmHg in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). The mean heart rate of patients was 92.27 ± 4.71 beats per min (bpm) in 0.75% Bupivacaine group while 97.68 ± 4.58 bpm in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). Conclusion: 0.5% hyperbaric Bupivacaine was better than 0.75% hyperbaric Bupivacaine solution in spinal anaesthesia during caesarean section.


Author(s):  
Mooventhan A, MD ◽  
Sneha Bharati, BNYS ◽  
Nivethitha L, PhD ◽  
Manjunath NK, PhD

Background: Ice massage is one of the common hydrotherapeutic procedures. The current study is first of its kind, conducted to evaluate the effect of ice massage to head and spine on blood pressure and heart rate variability in patients with hypertension. Materials and Methods: Fifteen hypertensive subjects with the mean ± standard deviation (SD) age of 48.87 ± 11.17 yrs were recruited and underwent only one session of ice massage to head and spine for 20 min. Blood pressure and heart rate variability were assessed before and immediately after the intervention. Results: Results of this study showed a significant reduction in systolic blood pressure (p = <.001), diastolic blood pressure (p < .001) and heart rate (p = .012), and a significant increase in R-R Interval (the intervals between adjacent R waves in the electro cardiogram) (p = .001) in the posttest assessments compared to its respective pre-test assessments. Conclusion: Results suggest that 20 min of ice massage to head and spine may reduce blood pressure and heart rate in patients with hypertension. However, there is no evidence that this provides any significant clinical impact for the patient.


2017 ◽  
Vol 11 (1) ◽  
pp. 146-155 ◽  
Author(s):  
Teshale Ayele Mega ◽  
Nikodimos Eshetu Dabe

Background:About 20 million people worldwide are believed to be using khat. Although some studies reported that khat chewing might result in cardiovascular disorders, conclusive evidence is limited.Method:The objective of this review was to synthesize the best available evidence for the effect of khat on the cardiovascular system. Databases searched were PubMed, Cochrane database of systematic reviews, CINAHL, poplin, LILACS, MedNar and Scopus. All papers included in the review were subjected to rigorous appraisal using the Joanna Briggs Institute (JBI) standardized critical appraisal tool. Review Manager Software (Revman 5.3) was used for meta-analysis and effect size and the 95% confidence interval (CI) was calculated.Result:Data was extracted from 10 articles. Our meta-analysis included 9,207 subjects, (2123 chewers and 7084 non-chewers, respectively) to elucidate the effect of khat on heart rate, diastolic and systolic blood pressure. The mean diastolic and systolic blood pressure of khat chewers was higher than the non-chewers with a mean difference of 5.1 mmHg, 95%CI [2.7,7.5] and 7.9 mmHg, 95%CI [2.65, 13.18], respectively. Similarly, the heart rate of the chewers remained consistently higher, making the mean difference of 6.9 beats/min, 95%CI [0.5, 13.3]. In addition, khat was found to have either a causative or worsening effect on stroke, myocardial infarction and heart failure.Conclusion:We showed that khat chewing could significantly affect the cardiovascular system through its effect on heart rate and blood pressure. Therefore, health promotion should be aimed to encourage quitting khat chewing.


Sign in / Sign up

Export Citation Format

Share Document