Endocarditis electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2] Maliha Shakil, M.D. [3]


On EKG, endocarditis may be characterized by conduction abnormalities, low QRS voltage, ST elevation, heart block, ventricular tachycardia, and supraventricular tachycardia.


An ECG may be helpful in the diagnosis of endocarditis. Findings on an ECG diagnostic of endocarditis include:[1][2][3][4]

This is an electrocardiogram from a man in his 80's. The patient has severe lung disease, has mitral regurgitation secondary to bacterial endocarditis , and is taking digoxin, Lasix and potassium. The electrocardiogram shows sinus rhythm and a QRS with a left axis deviation, a QRS duration of 118 milliseconds and a tall R wave in the first precordial lead V1 with an R wave height of approximately 21 mm. The prolonged QRS duration and the S waves that are seen as lead 1 and lead 6 suggest a right on the branch block and a left axis deviation suggests a left anterior semi-block. Finally the tall R wave in V1 lead suggests right ventricular hypertrophy.
Electrocardiogram. Day 1 ECG on left and day 2 on right. Day 1 ECG reveals probable sinus tachycardia with first-degree heart block at 111 bpm. Day 2 ECG shows complete heart block with a ventricular rate of 67 bpm. Case courtesy by Shahzad Khan et al[5]


  1. Brancheau D, Degheim G, Machado C (2015). "Timing for pacing after acquired conduction disease in the setting of endocarditis". Case Rep Cardiol. 2015: 471046. doi:10.1155/2015/471046. PMC 4300147. PMID 25628898.
  2. Khan S, Smyrlis A, Yaranov D, Oelberg D, Jimenez E (2015). "A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review". Case Rep Cardiol. 2015: 291079. doi:10.1155/2015/291079. PMC 4469760. PMID 26146571.
  3. Orme J, Rivera-Bonilla T, Loli A, Blattman NN (2015). "Native Valve Endocarditis due to Ralstonia pickettii: A Case Report and Literature Review". Case Rep Infect Dis. 2015: 324675. doi:10.1155/2015/324675. PMC 4306225. PMID 25648998.
  4. Bathina JD, Yusuf SW (2011). "Myocardial Infarction due to Endocarditis". Cardiol Res Pract. 2011: 950483. doi:10.4061/2011/950483. PMC 3035002. PMID 21318108.
  5. "A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review".

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