Rheumatic fever electrocardiogram
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S.; Anthony Gallo, B.S. [2]
Overview
On electrocardiogram, rheumatic fever is characterized by PR interval prolongation, conduction abnormalities, arryhthmias, or P mitrale depending on the structures involved and the extent of cardiac damage.
Electrocardiogram
ECG changes depend on the structures involved and the extent of cardiac damage. The following ECG changes may be noted in patients with rheumatic fever:[1][2]
- Sinus tachycardia or bradycardia depending on vagal tone
- Prolongation of PR interval
- Variable degree of AV conduction block
![](/images/6/65/2to1AVBlock1.jpg)
- P mitrale secondary to mitral valve abnormalities
![](/images/4/4f/LAE_12lead.jpg)
- Mitral valve abnormalities which may lead to development of atrial flutter or atrial fibrillation
- T-wave inversions which may be noted in leads I, II and IV suggestive of pericardial involvement
- ST segment elevation may also be present in leads II, III, aVF and V4 to V6 in patients with acute pericarditis
References
- ↑ SOKOLOW M (1947). "The electrocardiogram in the diagnosis and management of rheumatic fever". Calif Med. 66 (4): 221–6. PMID 20294585.
- ↑ KAHN J, SHAPIRO E, LIPKIS ML (December 1948). "The electrocardiogram in rheumatic fever". Calif Med. 69 (6): 449–52. PMC 1643649. PMID 18099073.
- ↑ Image courtesy of ECGPedia (2015). http://en.ecgpedia.org/wiki/Short_coupled_Torsades_de_Pointes Accessed on October 19, 2015.