Congestive heart failure electrocardiogram: Difference between revisions

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'''[[Left bundle branch block]] ([[LBBB]]):''' can be observed in both ischemic and non-ischemic cases of heart failure
'''[[Left bundle branch block]] ([[LBBB]]):''' can be observed in both ischemic and non-ischemic cases of heart failure
'''[[Left ventricular hypertrophy]]:''' consistent with a history of [[hypertension]] can be seen
'''[[Left ventricular hypertrophy]]:''' consistent with a history of [[hypertension]] can be seen
'''[[Left atrial enlargement]]'''
'''[[Left atrial enlargement]]'''
'''[[Non-specific ST segment and T wave changes]]'''
'''[[Non-specific ST segment and T wave changes]]'''



Revision as of 20:36, 1 April 2012

Congestive Heart Failure Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Systolic Dysfunction
Diastolic Dysfunction
HFpEF
HFrEF

Causes

Differentiating Congestive heart failure from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Clinical Assessment

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

Cardiac MRI

Echocardiography

Exercise Stress Test

Myocardial Viability Studies

Cardiac Catheterization

Other Imaging Studies

Other Diagnostic Studies

Treatment

Invasive Hemodynamic Monitoring

Medical Therapy:

Summary
Acute Pharmacotherapy
Chronic Pharmacotherapy in HFpEF
Chronic Pharmacotherapy in HFrEF
Diuretics
ACE Inhibitors
Angiotensin receptor blockers
Aldosterone Antagonists
Beta Blockers
Ca Channel Blockers
Nitrates
Hydralazine
Positive Inotropics
Anticoagulants
Angiotensin Receptor-Neprilysin Inhibitor
Antiarrhythmic Drugs
Nutritional Supplements
Hormonal Therapies
Drugs to Avoid
Drug Interactions
Treatment of underlying causes
Associated conditions

Exercise Training

Surgical Therapy:

Biventricular Pacing or Cardiac Resynchronization Therapy (CRT)
Implantation of Intracardiac Defibrillator
Ultrafiltration
Cardiac Surgery
Left Ventricular Assist Devices (LVADs)
Cardiac Transplantation

ACC/AHA Guideline Recommendations

Initial and Serial Evaluation of the HF Patient
Hospitalized Patient
Patients With a Prior MI
Sudden Cardiac Death Prevention
Surgical/Percutaneous/Transcather Interventional Treatments of HF
Patients at high risk for developing heart failure (Stage A)
Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B)
Patients with current or prior symptoms of heart failure (Stage C)
Patients with refractory end-stage heart failure (Stage D)
Coordinating Care for Patients With Chronic HF
Quality Metrics/Performance Measures

Implementation of Practice Guidelines

Congestive heart failure end-of-life considerations

Specific Groups:

Special Populations
Patients who have concomitant disorders
Obstructive Sleep Apnea in the Patient with CHF
NSTEMI with Heart Failure and Cardiogenic Shock

Congestive heart failure electrocardiogram On the Web

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Directions to Hospitals Treating Congestive heart failure electrocardiogram

Risk calculators and risk factors for Congestive heart failure electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Although there is no diagnostic criteria of congestive heart failure on the EKG, there may be signs of the underlying cardiac cause(s) of congestive heart failure.

Electrocardiographic Abnormalities in Congestive Heart Failure

Low QRS Voltage: The EKG often shows low QRS voltage. There are two broad underlying causes of low QRS voltage in the patient with heart failure:

  1. Electrically inert myocardium due to a loss of viable myocardium
  2. Infiltration of the myocardium (myxedematous, Chagas disease)

In alphabetical order the differential diagnosis of causes of low QRS voltage in the patient with heart failure includes:

Poor R wave progression: Poor R wave progression in the precordial leads may be secondary to a prior myocardial infarction but can also be observed in the absence of a prior myocardial infarction in the patient with heart failure.

Left bundle branch block (LBBB): can be observed in both ischemic and non-ischemic cases of heart failure

Left ventricular hypertrophy: consistent with a history of hypertension can be seen

Left atrial enlargement

Non-specific ST segment and T wave changes

References

  1. 1.0 1.1 Madias JE (2008). "Low QRS voltage and its causes". J Electrocardiol. 41 (6): 498–500. doi:10.1016/j.jelectrocard.2008.06.021. PMID 18804788.
  2. Chinitz JS, Cooper JM, Verdino RJ (2008). "Electrocardiogram voltage discordance: interpretation of low QRS voltage only in the limb leads". J Electrocardiol. 41 (4): 281–6. doi:10.1016/j.jelectrocard.2007.12.001. PMID 18353352.

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