scholarly journals Low QRS Voltage in Limb Leads Indicates Accompanying Precordial Voltage Attenuation Resulting in Underestimation of Left Ventricular Hypertrophy

2021 ◽  
Vol 18 (24) ◽  
pp. 12867
Author(s):  
Hye-Bin Gwag ◽  
Su-Hyun Lee ◽  
Hyeon-Jun Kim ◽  
June-Soo Kim ◽  
Young-Keun On ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Healthy Population ◽  
Primary Analysis ◽  
X Ray ◽  
Function Test ◽  
Chest X Ray ◽  
Voltage Attenuation

Low QRS voltage (LQRSV) in electrocardiography (ECG) often occurs in limb leads without apparent cause. However, its clinical significance is obscure in healthy populations. We reviewed patients aged over 60 who were scheduled for non-cardiac surgery in two hospitals. Patients underwent pre-operative ECG, echocardiography, pulmonary function test, and chest X-ray. Patients with LQRSV isolated to limb leads and patients without LQRSV were selected from separate hospitals. Among the 9832 patients screened in one hospital, 292 (3.0%) showed LQRSV in limb leads. One-hundred and ninety-four without LQRSV were selected as the control from the 216 patients screened at the other hospital. For primary analysis, patients with structural heart disease or classic etiologies of LQRSV were excluded. Patients with LQRSV had a higher proportion of male and a greater body mass index. Precordial QRS voltages were smaller, whereas left ventricular mass index and the prevalence of echocardiographic left ventricular hypertrophy (LVH) was higher in patients with LQRSV than in those without. Consequentially, diagnostic performance of precordial voltage criteria for LVH was particularly poor in patients with LQRSV in limb leads. LQRSV in limb leads frequently occurs without apparent etiologies. ECG voltage criteria may underestimate LVH in a relatively healthy population with LQRSV in limb leads.

TO CORRELATE ECG CHANGES AND CLINICO-RADIOLOGICAL FINDINGS WITH THE SEVERITY OF VSD.

2020 ◽  
Vol 4 (12) ◽  
Author(s):  
Deepak Kumar Uikey ◽  
Ankur Roy
Keyword(s):  
Pulmonary Hypertension ◽  
Ventricular Hypertrophy ◽  
Septal Defect ◽  
Left Ventricular ◽  
Age Group ◽  
Radiological Findings ◽  
Ecg Changes ◽  
X Ray ◽  
Chest X Ray ◽  
Grade Ii

Background & Method: This study was conducted in 56 children in age group of 02 months to 14 years with Echocardio graphically proved Ventricular Septal Defect, over a period of 01 and a half year, after taking consent from the parents and explaining them the purpose and method of this study. Result: Out of these 27 patients in 2 to 6 months age group, 11 were large VSDs, 16 were moderate VSDs and 2 were small VSDs. Out of 17 patients in age group 6 to 12 months, 10 patients were large VSDs, 5 patients had moderate VSDs and 3 patients were with small VSDs. Among patients with moderate VSDs only 4out of 25 patients had signs of right ventricular hypertrophy (16%). Left ventricular hypertrophy was evident clinically in 24 patients out of 25 (96%) & obviously no patients had biventricular hypertrophy. A loud ESM was heard (grade II-IV). Conclusion: Clinical examination can also suggest LVH in moderate VSD & sometimes BVH in large VSD, Palpable P2 and loud P2 are very important findings that suggest pulmonary hypertension. Pansystolic murmur is heard in small-moderate VSD and ESM in large VSD. Complications like CCF, pulmonary hypertension, malnutrition and FTT are mostly present in moderate-large VSD. Chest x-ray suggests cardiomegaly, plethora and also enlargement of PA segment in moderate –large VSD. Keywords: ECG, Clinico-radiological, VSD & Severity. Study Designed: Observational Study.

Occurrence of intramitochondrial Ca2+ granules in a hypertrophied heart exposed to adriamycin

1984 ◽  
Vol 62 (9) ◽  
pp. 1239-1244 ◽  
Author(s):  
Pawan K. Singal ◽  
Michael S. Forbes ◽  
Nick Sperelakis
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Cell Damage ◽  
Myocardial Cell ◽  
Left Ventricular ◽  
Sham Control ◽  
Hypertrophied Heart ◽  
X Ray ◽  
Myocardial Cell Damage ◽  
Increased Susceptibility

Left ventricular hypertrophy was produced in rabbits by narrowing the abdominal aorta in the subdiaphragmatic region. Six weeks after the surgery, sham control as well as hypertrophied animals were treated with adriamycin. Myocardial cell damage resulting from a total cumulative dose of 5 mg/kg of adriamycin was seen only in hypertrophied hearts. Alterations in muscle cells of these hearts included prominent "contraction bands" and perinuclear edema. Mitochondria were characterized by swelling and accumulation of electron-opaque granules. Energy-dispersive x-ray analysis of the mitochondria revealed the presence of calcium in these granules. The study confirms that the hypertrophied heart is more vulnerable to adriamycin-induced cell damage and this may be due to an increased susceptibility of these hearts to the occurrence of Ca2+ overload in the cell.

scholarly journals A STUDY ON CLINICAL PROFILE OF THE PATIENTS WITH CONGESTIVE HEART FAILURE

2020 ◽  
pp. 76-78
Author(s):  
Dharmendra Prasad ◽  
Mahendra Kumar ◽  
Raj Kumar Deepak ◽  
Sumit Kumar ◽  
Debarshi Jana
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Ventricular Hypertrophy ◽  
Prospective Observational Study ◽  
Left Ventricular ◽  
Clinical Profile ◽  
X Ray ◽  
Medical College ◽  
Multiple Risk Factors ◽  
Chest X Ray

Background: Heart failure (HF) is a common cardiovascular condition whose prevalence and incidence is increasing in the recentpast. Multiple risk factors involved in its genesis makes it more complex in the prevention and management. Objective: The present study aimed to assess the clinical profile of the patients suffering with heart failure. Methods: Prospective observational study was undertaken among the patients admitted in the Medical unit of Govt. Medical College and Hospital, Bettiah during October 2018 and September 2019. Patients fulfilling EuropeanSociety of Cardiology (ESC) criteria of HF were included in the study. Prevalence of congestive HF was estimated based on community study and hospital OPD. Results: Smoking, alcoholism, ischemic heart disease and hypertension were the leading risk factors in developing HF. Breathlessness(100%), swelling of the feet (92.3%), cough (57.7%) and palpitation (50%) were the most common symptoms observed inthe patients. Oedema feet (100%), basal crepitations (80.3%), raised Jugular Venous Distention (JVD) (57.7%) and S3 (57.7%)were the leading signs in the patients. Chest X-ray (CXR) findings indicate that 76.9% of the patients reported with increasedCardiothoracic ratio. Arrhythmias (predominantly AF-19.2%) and Left Ventricular Hypertrophy (LVH) accounted for 26.9% each. The prevalence of HF was estimated to be in between 0.51 to 27.27 respectively.

Left Ventricular Hypertrophy

2014 ◽  
Vol 19 (2) ◽  
pp. 11-15
Author(s):  
Steven L. Demeter
Keyword(s):  
Risk Factors ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular Mass Index ◽  
Medical Science ◽  
Careful Analysis ◽  
Left Ventricular ◽  
Hypertensive Disease ◽  
Accurate Analysis ◽  
Clear Explanation

Abstract The fourth, fifth, and sixth editions of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) use left ventricular hypertrophy (LVH) as a variable to determine impairment caused by hypertensive disease. The issue of LVH, as assessed echocardiographically, is a prime example of medical science being at odds with legal jurisprudence. Some legislatures have allowed any cause of LVH in a hypertensive individual to be an allowed manifestation of hypertensive changes. This situation has arisen because a physician can never say that no component of LVH was not caused by the hypertension, even in an individual with a cardiomyopathy or valvular disorder. This article recommends that evaluators consider three points: if the cause of the LVH is hypertension, is the examinee at maximum medical improvement; is the LVH caused by hypertension or another factor; and, if apportionment is allowed, then a careful analysis of the risk factors for other disorders associated with LVH is necessary. The left ventricular mass index should be present in the echocardiogram report and can guide the interpretation of the alleged LVH; if not present, it should be requested because it facilitates a more accurate analysis. Further, if the cause of the LVH is more likely independent of the hypertension, then careful reasoning and an explanation should be included in the impairment report. If hypertension is only a partial cause, a reasoned analysis and clear explanation of the apportionment are required.

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