Dilated cardiomyopathy electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]

Overview

ECG may show evidence of left ventricular hypertrophy, atrial fibrillation or premature ventricular complexes, or conduction delays, AV nodal block, or left bundle branch block may be observed.

Electrocardiogram

ECG may show evidence of the following findings:

Some studies have shown that left ventricular hypertrophy, altered heart rate, and anterolateral T-wave inversion can predict the risk of mortality or heart transplantation in dilated cardiomyopathy patients.[1][2]

There is marked LVH (S wave in V2 > 35 mm) with dominant S waves in V1-4. There is evidence of right axis deviation, left atrial enlargement, and peaked p waves in lead II. Case courtesy of Dr Ed Burns [3]
Left ventricular hypertrophy with large precordial voltages and an LV strain pattern in leads with a dominant R wave (I, II, V6). There is also evidence of biatrial enlargement in V1. Case Courtsy of Dr Ed Burns. [4]


References

  1. Merlo M, Zaffalon D, Stolfo D, Altinier A, Barbati G, Zecchin M; et al. (2019). "ECG in dilated cardiomyopathy: specific findings and long-term prognostic significance". J Cardiovasc Med (Hagerstown). 20 (7): 450–458. doi:10.2459/JCM.0000000000000804. PMID 30985353.
  2. Momiyama Y, Mitamura H, Kimura M (1994). "ECG characteristics of dilated cardiomyopathy". J Electrocardiol. 27 (4): 323–8. doi:10.1016/s0022-0736(05)80270-5. PMID 7815010.
  3. https://litfl.com/wp-content/uploads/2018/08/ECG-Ischaemic-dilated-cardiomyopathy-1.jpg
  4. https://litfl.com/wp-content/uploads/2018/08/ECG-Idiopathic-dilated-cardiomyopathy-Biatrial-hypertrophy.jpg

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