scholarly journals The mortal cause of sudden ECG changes in patients with chronic aortic insufficiency: Aortic dissection

2019 ◽  
Vol 11 (1) ◽  
pp. 68-70
Author(s):  
Mahmut Yesin ◽  
Turgut Karabağ ◽  
Macit Kalçık ◽  
Süleyman Karakoyun ◽  
Metin Çağdaş ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Dissection ◽  
Signs And Symptoms ◽  
Aortic Insufficiency ◽  
Ecg Changes ◽  
St Segment Elevation ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment ◽  
High Index Of Suspicion

The symptoms of aortic dissection (AD) may be highly variable and may mimic other much common conditions. Thus, a high index of suspicion should be maintaned, especially when the risk factors for AD are present or signs and symptoms suggest this possibility. However, sometimes AD may be asymptomatic or progression may be subclinical. Various electrocardiographical (ECG) changes may be seen in AD patients such as ST segment elevation in aVR as well as ST segment depression and T-wave inversion. In this case report, we reported a patient with acute AD whose ECG revealed ST segment elevation in aVR lead in addition to diffuse ST segment depression in other leads.

Abstract 4840: Tako-Tsubo Cardiomyopathy without Apical Ballooning - Results of the German Tako-Tsubo Registry

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Anastasios Athanasiadis ◽  
Birke Schneider ◽  
Johannes Schwab ◽  
Uta Gottwald ◽  
Ellen Hoffmann ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Ejection Fraction ◽  
Wall Motion ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment ◽  
Tako Tsubo Cardiomyopathy

Background : The German tako-tsubo cardiomyopathy (TTC) registry has been initiated to further evaluate this syndrome in a western population. We aimed to assess different patterns of left ventricular involvement in TTC. Methods : Inclusion criteria were: 1) acute chest symptoms, 2) reversible ECG changes (ST-segment elevation±T-wave inversion), 3) reversible left ventricular dysfunction with a wall motion abnormality not corresponding to a single coronary artery territory, 4) no significant coronary artery stenoses. Results : A total of 258 patients (pts) from 33 centers were included with a mean age of 68±12 years. Left ventriculography revealed the typical pattern of apical ballooning in 170 pts (66%) and an atypical mid-ventricular ballooning with normal wall motion of the apical and basal segments in 88 pts (34%). Mean age (68±11 vs 67±13 years) and gender distribution (150 women/20 men vs 80 women/8 men) were similar in both groups. Triggering events were present in 78% of the pts with apical ballooning (35% emotional, 34 physical and 9% combination) and in 75% of the pts with mid-ventricular ballooning (39% emotional, 25% physical and 11% combination). As assessed by left ventriculography, ejection fraction was significantly lower in pts with mid-ventricular ballooning (50±15% vs 45±13%, p=0.006). There was no difference in right ventricular involvement. Creatine kinase and troponin I were comparable in both groups. The ECG on admission showed ST-segment elevation in 87% of pts with apical ballooning and in 78% of pts with mid-ventricular ballooning. T-wave inversion was seen in 70% of the pts irrespective of the TTC variant. A Q-wave was significantly less present in pts with mid-ventricular ballooning (30% vs 16%, p=0.04). The QTc interval during the first 3 days was not different among both groups. Conclusion : A variant form with mid-ventricular ballooning was observed in one third of the pts with TTC. Left ventricular ejection fraction was significantly lower in these pts, although they revealed significantly less Q-waves on the admission ECG. All other parameters were similar and confirm the concept that apical and mid-ventricular ballooning represent two different manifestations of the same syndrome.

ECG features and arrhythmias in takotsubo syndrome

ESC CardioMed ◽  
2018 ◽  
pp. 1298-1301
Author(s):  
Federico Migliore ◽  
Sebastiano Gili ◽  
Domenico Corrado
Keyword(s):  
Left Ventricular ◽  
Stunned Myocardium ◽  
Takotsubo Syndrome ◽  
St Segment Elevation ◽  
T Wave ◽  
Wave Inversion ◽  
Qt Interval Prolongation ◽  
St Segment ◽  
Reversible Left Ventricular Dysfunction ◽  
Repolarization Abnormalities

Takotsubo syndrome (TTS) is typically characterized by dynamic electrocardiographic (ECG) repolarization changes, which consist of mild ST-segment elevation on presentation (acute phase) followed by T-wave inversion with QT interval prolongation within 24–48 h after presentation (subacute phase). It is noteworthy that subacute ECG repolarization abnormalities of TTS resemble those of the so-called Wellens’ ECG pattern, which is characterized by transient T-wave inversion in the anterior precordial leads as a result of either myocardial ischaemia or other non-ischaemic conditions, all characterized by a reversible left ventricular dysfunction (‘stunned myocardium’).

scholarly journals ST segment elevation and depression, and T-wave changes as electrophysiological signs of metabolic disorders with lipid and non-lipid risk factors for ischemic heart disease in the 25–44-year-old population

2021 ◽  
Vol 10 (4) ◽  
pp. 29-38
Author(s):  
N. A. Kuzminykh ◽  
L. V. Shcherbakova ◽  
V. S. Shramko ◽  
D. V. Denisova ◽  
Yu. I. Ragino
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Metabolic Disorders ◽  
Density Lipoprotein ◽  
Ischemic Heart ◽  
St Segment Elevation ◽  
T Wave ◽  
St Segment ◽  
St Elevation

Aim. To study the associations of electrophysiological signs of metabolic disorders with lipid and non-lipid risk factors in the urban 25–44-year-old population.Methods. A population survey (random sample) of Novosibirsk residents aged 25–44 years (656 men, 783 women) was conducted. The concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and triglycerides were determined. Systolic / diastolic blood pressure, body mass index, presence of arterial hypertension, and smoking status were evaluated. The following electrocardiographic markers of metabolic disturbances were analyzed: baseline non-ischemic ST elevation depression >0.5 mm, baseline ST elevation >0.5 mm, and T-wave changes (flattening, amplitude reduction, inversion).Results. ST segment depression was detected in 4.2% of subjects (5.8% women, 2.4% men (p = 0.001)). ST segment elevation was detected in 28.5% of subjects (17.5% women, 41.6% men (p<0.001)). T-wave changes were detected in 18.9% of subjects (14.2% women, 24.5% men (p<0.001)). It was noted that men with elevated LDL-C levels and hypertension were more likely to have ST segment depression (1.4 and 1.9 times, respectively) than men without these abnormalities. In the general population, people with elevated LDL-C levels were 1.2 times more likely to have ST segment depression. Among men with ST segment elevation the concentration of LDL-C in the blood was 1.06 times higher than in men without ST segment elevation. People with a higher body mass index were 1.15 and 1.3 times more likely to have a T-wave change (in the general and female population, respectively). In the general population with T-wave changes, waist circumference and systolic blood pressure level were 1.02 and 1.02 times higher, respectively.Conclusion. ST segment elevation and depression, and T-wave changes are associated with lipid and non-lipid risk factors for ischemic heart disease. The data obtained indicate a potentiating effect of metabolic disorders in the body on the development of risk factors for ischemic heart disease and metabolic cardiomyopathy.

Proximal RCA occlusion producing anterior ST segment elevation, Q waves, and T wave inversion

2018 ◽  
Vol 51 (3) ◽  
pp. 511-515 ◽  
Author(s):  
Brooks Walsh ◽  
Ken Grauer ◽  
Edward R. Tuohy ◽  
Stephen W. Smith
Keyword(s):  
St Segment Elevation ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment

scholarly journals Abnormal Q Wave, ST-Segment Elevation, T-Wave Inversion, and Widespread Focal Myocytolysis Associated With Subarachnoid Hemorrhage

1996 ◽  
Vol 60 (4) ◽  
pp. 254-257 ◽  
Author(s):  
Hironosuke Sakamoto ◽  
Hiroshi Nishimura ◽  
Kouji lmataka ◽  
Keiko leki ◽  
Toshinobu Horie ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
St Segment Elevation ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment ◽  
Q Wave

scholarly journals Correlation of the ECG changes (ST segment depression with or without T wave inversion in lateral leads 1, avl. V4-V6) with coronary angiographic findings in ACS patients

2014 ◽  
Vol 9 (1) ◽  
pp. 9-12
Author(s):  
Mohammad Golam Azam ◽  
SME Al-Baker ◽  
Zillur Rahman ◽  
Md M Rahman ◽  
Chowdhury M Ahmed ◽  
...  
Keyword(s):  
Ecg Changes ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment ◽  
Angiographic Findings

No Abstract Available.DOI: http://dx.doi.org/10.3329/uhj.v9i1.19431 University Heart Journal Vol. 9, No. 1, January 2013; 9-12

scholarly journals A STUDY OF ELECTROCARDIOGRAPHIC FINDINGS IN PATIENTS WITH ACUTE CVA

2020 ◽  
pp. 11-13
Author(s):  
Prasad Ugaragol ◽  
Edwin Jose
Keyword(s):  
Cerebral Infarction ◽  
Cerebral Hemorrhage ◽  
P Wave ◽  
Electrolyte Imbalance ◽  
St Segment Elevation ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment ◽  
Electrocardiographic Findings ◽  
Ecg Abnormalities

Background - Electrocardiographic abnormalities are common in patients with acute CVA, the possible mechanism of which is the disturbances in autonomic regulation and excessive stimulation of sympathetic nervous system resulting in disordered repolarization process. Physicians are often confronted due to ECG abnormalities in acute CVA since it often mimick that of myocardial ischemia. The present study was undertaken with the objective to describe the frequency and pattern of common ECG abnormalities in CVA. Methodology - This is a retrospective case series study conducted among patients with acute stroke admitted to HSK hospital bagalkot during February 2020 - August 2020. A 12 lead ECG of cases fulfilling the inclusion and exclusion criteria of our study were evaluated for characters like P wave,PR segment, QRS,ST segment, Q wave etc. Sample size estimation was done using open epi Software version 2.3.1 Results - Among the 90 cases, 70% had abnormal ECG. Among cerebral infarction 61(67.7%) cases, ST segment depression was found in 21(34.4%), Qtc prolongation in 16(26.2%), T wave inversion in 13(21.3%) and wide QRS in 14(22.9%). Among cerebral hemorrhage 24(26.6%), prolonged QTc was found in 10(41.6%), T wave inversion in 9(37.5%), ST segment elevation in 6(25%) and tall T wave in 4(16.6%) patients. In SAH patients, ST segment elevation was found in 2(40%), tall T wave in 2(40%), and T wave inversion in 2(40%). Conclusion - Abnormal electrocardiographic findings are common in patients with acute cerebrovascular accidents even in the absence of electrolyte imbalance or known organic heart disease. ECG abnormalities like ST segment elevation, tall T wave, T wave inversion, and prolonged QTc were commoner in cerebral infarction than in cerebral hemorrahge whereas ST segment depression was predominantly found in patients with cerebral hemorrhage. Understanding that these abnormalities are associated with acute CVA is important to avoid erroneous judgment of assigning these patients as having cardiac dysfunction.

Abstract 15688: Electrocardiographic Patterns Differentiating "Apical Ballooning" From Anterior Myocardial Infarction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Birke Schneider ◽  
Kay Peters ◽  
Udo Desch ◽  
Jürgen Stein
Keyword(s):  
Myocardial Infarction ◽  
Adverse Events ◽  
Apical Ballooning ◽  
Qtc Interval ◽  
Anterior Myocardial Infarction ◽  
St Segment Elevation ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment

Introduction: Left ventricular apical ballooning (AB) mimics anterior myocardial infarction (AMI). This study assessed if the ECG can differentiate between these two syndromes with a similar clinical presentation. Methods: Among 2086 patients (pts) with an ACS, 33 (1.6%) with AB were identified (29 f, 4 m, median age 77 years) and compared to 28 consecutive age and sex matched AMI pts undergoing PCI of the LAD with similar findings on LV angiography. Results: AB pts arrived at the hospital later after symptom onset (median 21 vs 5 hours; p<0.001). On the admission ECG, the number of leads with ST-segment elevation (4 [3-6] vs 5 [5-7], p=0.005) and the magnitude of ST-segment elevation (0.7 [0.5-0.9] vs 0.9 [0.7-1.5] mV, p=0.002) were greater in AMI. Reciprocal ST-segment depression was similar (27% vs 54%, p=ns). A positive T wave in aVR was more frequent in AB (49% vs 7%, p<0.001). During follow-up, AB pts had more leads with T-wave inversion (8 [8-9] vs 6 [5-8], p<0.001) and a larger magnitude of T-wave inversion (2.9 [2.2-4.6] vs 1.4 [0.9-2.3] mV, p<0.001). T-wave inversion was similar in I, aVL and V2-V5. AB pts, however, showed negative T-waves also in lead II (74% vs 22%, p<0.001), III (34% vs 4%, p=0.004), aVF (51% vs 11%, p=0.001) and a positive T wave in aVR (100% vs 70%, p=0.005). The QTc interval was longer in AB (515 [482-543] vs 458 [435-484] ms, p<0.001). An abnormal Q wave on admission was more frequent in AMI (21% vs 79%, p<0.001) and persisted but was absent in AB at discharge (0% vs 61%, p<0.001). Ventricular tachycardia was similar (2% vs 14%, p=ns) but atrial fibrillation occurred only in AB (21% vs 0%, p=0.013). The ECG normalized in all AB but in only 1 AMI pt (p<0.001). Overall, despite a similar ejection fraction (54±15 vs 55±13 %) and lower troponin I values (7.5±6.9 vs 238±221 ng/ml, p<0.001), AB pts developed significantly more adverse events compared to AMI pts (52% vs 18%, p<0.008). Conclusion: ECG patterns in AB are significantly different from those in AMI. On admission, the extent of ST-segment elevation and the number of Q waves are greater in AMI. During follow-up, no Q wave, a longer QTc interval, a greater extent of T-wave inversion and a positive T wave in aVR are typical findings in AB. Adverse events are more frequent in AB than in AMI.

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