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== Overview ==
== Overview ==
On [[EKG]], endocarditis may be characterized by conduction abnormalities, low QRS voltage, ST elevation, [[heart block]], [[ventricular tachycardia]], and [[supraventricular tachycardia]].
On [[EKG]], [[endocarditis]] may be characterized by conduction abnormalities, low [[QRS complex|QRS]] voltage, [[ST elevation]], [[heart block]], [[ventricular tachycardia]], and [[supraventricular tachycardia]].


== Electrocardiogram ==
== Electrocardiogram ==
An ECG may be helpful in the diagnosis of endocarditis. Findings on an ECG diagnostic of endocarditis include:<ref name="sd"> Electrocardiographic findings in infective endocarditis. Science Direct. URL=http://www.sciencedirect.com/science/article/pii/0736467988901539 Accessed on September 25, 2015</ref>
An [[ECG]] may be helpful in the diagnosis of [[endocarditis]]. Findings on an [[ECG]] diagnostic of [[endocarditis]] include:<ref name="pmid25628898">{{cite journal| author=Brancheau D, Degheim G, Machado C| title=Timing for pacing after acquired conduction disease in the setting of endocarditis. | journal=Case Rep Cardiol | year= 2015 | volume= 2015 | issue=  | pages= 471046 | pmid=25628898 | doi=10.1155/2015/471046 | pmc=4300147 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25628898  }}</ref><ref name="pmid26146571">{{cite journal| author=Khan S, Smyrlis A, Yaranov D, Oelberg D, Jimenez E| title=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. | journal=Case Rep Cardiol | year= 2015 | volume= 2015 | issue=  | pages= 291079 | pmid=26146571 | doi=10.1155/2015/291079 | pmc=4469760 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26146571  }}</ref><ref name="pmid25648998">{{cite journal| author=Orme J, Rivera-Bonilla T, Loli A, Blattman NN| title=Native Valve Endocarditis due to Ralstonia pickettii: A Case Report and Literature Review. | journal=Case Rep Infect Dis | year= 2015 | volume= 2015 | issue=  | pages= 324675 | pmid=25648998 | doi=10.1155/2015/324675 | pmc=4306225 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25648998  }}</ref><ref name="pmid21318108">{{cite journal| author=Bathina JD, Yusuf SW| title=Myocardial Infarction due to Endocarditis. | journal=Cardiol Res Pract | year= 2011 | volume= 2011 | issue=  | pages= 950483 | pmid=21318108 | doi=10.4061/2011/950483 | pmc=3035002 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21318108  }}</ref>


* Increased [[PR interval]]
* Increased [[PR interval]]


*Conduction abnormalities  
*[[Conduction System|Conduction]] abnormalities
*Low QRS voltage, ST elevation  
*[[Atrioventricular]] [[Dissociation (psychology)|dissociation]] which includes atrioventricular block with accelerated junctional escape
*[[Heart block]]
*Low [[QRS]] voltage,
*[[Myocardial Infarction]] with [[ST interval|ST elevation]]
*[[Heart block]] which includes with [[first-degree heart block]] and [[complete heart block]]
*[[Ventricular tachycardia]]
*[[Ventricular tachycardia]]
*[[Supraventricular tachycardia]]
*[[Supraventricular tachycardia]]


[[Image:Endocarditis complications.jpg|center|800px|thumb|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]].]]
[[Image:Endocarditis complications.jpg|center|800px|thumb|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]].]]
 
[[File:First-degree heart block and complete heart block.jpg|alt=Electrocardiogram|center|thumb|710x710px|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<ref>{{Cite web|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4469760/|title=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|last=|first=|date=|website=|archive-url=|archive-date=|dead-url=|access-date=}}</ref>]]
<br />
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Latest revision as of 14:49, 4 March 2020

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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]

Overview

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

Electrocardiogram

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
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]


References

  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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