Hepatocellular carcinoma electrocardiogram: Difference between revisions
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{{CMG}} {{AE}} {{SH}} | {{CMG}} {{AE}} {{SH}} | ||
==Overview== | ==Overview== | ||
In a few patients with hepatocellular carcinoma metastasis to right ventricle may cause the [[The electrocardiogram|ECG]] to show low voltage in limb leads, diffuse [[T wave|T-wave]] [[T wave inversion|inversion]] and | In a few patients with hepatocellular carcinoma, [[metastasis]] to [[right ventricle]] may cause the [[The electrocardiogram|ECG]] to show low voltage in [[limb leads]], diffuse [[T wave|T-wave]] [[T wave inversion|inversion]] and [[QT prolongation|prolongation of the QT interval]]. | ||
==ECG | ==ECG Findings in Hepatocellular Carcinoma== | ||
Abnormalities of [[cardiac electrophysiology]] may be noted in hepatocellular carcinoma. Low voltage complexes in the [[limb leads]] may also be noticed in patients due to [[right ventricular]] metastasis. An ECG may be helpful in the diagnosis of [[Metastasis|metastatic]] hepatocellular carcinoma into the [[right ventricle]]. | Abnormalities of [[cardiac electrophysiology]] may be noted in cases of hepatocellular carcinoma. Low voltage complexes in the [[limb leads]] may also be noticed in patients due to [[right ventricular]] [[metastasis]]. An [[The electrocardiogram|ECG]] may be helpful in the [[diagnosis]] of [[Metastasis|metastatic]] hepatocellular carcinoma into the [[right ventricle]]. | ||
;Low voltage in limb leads and diffuse T-wave inversion<ref>{{Cite journal|last=Liu|first=Yu-Chun|date=2006|title=Asymptomatic Metastasis of Hepatocellular Carcinoma into the Right Ventricular Cavity Presenting with electrocardiographic Changes|url=http://www.tsoc.org.tw/upload/journal/1/20060930/12.pdf|journal=Acta Cardiol Sin|volume=22|pages=180-183|via=}}</ref> | ;Low voltage in limb leads and diffuse T-wave inversion | ||
* Findings on an ECG suggestive of metastasis of hepatocellular carcinoma into the right ventricle include low voltage in limb leads and diffuse [[T wave|T-wave]] [[T wave inversion|inversion]]<ref>{{Cite journal|last=Liu|first=Yu-Chun|date=2006|title=Asymptomatic Metastasis of Hepatocellular Carcinoma into the Right Ventricular Cavity Presenting with electrocardiographic Changes|url=http://www.tsoc.org.tw/upload/journal/1/20060930/12.pdf|journal=Acta Cardiol Sin|volume=22|pages=180-183|via=}}</ref> | |||
;QT interval prolongation | |||
*It is a sign of [[Cirrhosis|cirrhotic]] [[cardiomyopathy]].<ref name="pmid22149582">{{cite journal |author=Bernardi M, Maggioli C, Dibra V, Zaccherini G |title=QT interval prolongation in liver cirrhosis: innocent bystander or serious threat? |journal=[[Expert Review of Gastroenterology & Hepatology]] |volume=6 |issue=1 |pages=57–66 |year=2012 |pmid=22149582 |doi=10.1586/egh.11.86 |url=http://www.future-drugs.com/doi/abs/10.1586/egh.11.86?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed |accessdate=2012-09-06}}</ref> | |||
*It may be due to the following: | *It may be due to the following: | ||
**Circulating [[Toxin|toxins]] in the blood stream | **Circulating [[Toxin|toxins]] in the blood stream | ||
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**Stress due to [[hemorrhage]], [[shock]] or [[surgery]] ([[liver transplantation]]) | **Stress due to [[hemorrhage]], [[shock]] or [[surgery]] ([[liver transplantation]]) | ||
;Attenuation of ECG voltage <ref name="pmid17344308">{{cite journal |author=Madias JE |title=Attenuation of ECG voltage in cirrhotic patients |journal=[[Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology]] |volume=9 |issue=3 |pages=175–81 |year=2007 |pmid=17344308 |doi=10.1093/europace/eul182 |url=http://europace.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=17344308 |accessdate=2012-09-06}}</ref> | ;Attenuation of ECG voltage | ||
* Attenuation of ECG voltages is noticed mainly in patients who have [[ascites]] and peripheral [[edema]]<ref name="pmid17344308">{{cite journal |author=Madias JE |title=Attenuation of ECG voltage in cirrhotic patients |journal=[[Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology]] |volume=9 |issue=3 |pages=175–81 |year=2007 |pmid=17344308 |doi=10.1093/europace/eul182 |url=http://europace.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=17344308 |accessdate=2012-09-06}}</ref> | |||
* This finding may be corrected by placing leads [[Anatomical terms of location|cranially]]<ref>http://europace.oxfordjournals.org/content/10/1/96.abstract</ref> | * This finding may be corrected by placing leads [[Anatomical terms of location|cranially]]<ref>http://europace.oxfordjournals.org/content/10/1/96.abstract</ref> | ||
* [[Peripheral edema]] may be strongly correlated with this finding | * [[Peripheral edema]] may be strongly correlated with this finding | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Medicine]] | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Types of cancer]] | [[Category:Types of cancer]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | [[Category:Oncology]] | ||
[[Category:Hepatology]] | [[Category:Hepatology]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category:Emergency medicine]] | |||
Latest revision as of 22:08, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Overview
In a few patients with hepatocellular carcinoma, metastasis to right ventricle may cause the ECG to show low voltage in limb leads, diffuse T-wave inversion and prolongation of the QT interval.
ECG Findings in Hepatocellular Carcinoma
Abnormalities of cardiac electrophysiology may be noted in cases of hepatocellular carcinoma. Low voltage complexes in the limb leads may also be noticed in patients due to right ventricular metastasis. An ECG may be helpful in the diagnosis of metastatic hepatocellular carcinoma into the right ventricle.
- Low voltage in limb leads and diffuse T-wave inversion
- Findings on an ECG suggestive of metastasis of hepatocellular carcinoma into the right ventricle include low voltage in limb leads and diffuse T-wave inversion[1]
- QT interval prolongation
- It is a sign of cirrhotic cardiomyopathy.[2]
- It may be due to the following:
- Circulating toxins in the blood stream
- Drugs
- Stress due to hemorrhage, shock or surgery (liver transplantation)
- Attenuation of ECG voltage
- Attenuation of ECG voltages is noticed mainly in patients who have ascites and peripheral edema[3]
- This finding may be corrected by placing leads cranially[4]
- Peripheral edema may be strongly correlated with this finding
- Diuretic use in case of peripheral edema leads to improvement in ECG findings
- Paracentesis has no effect on ECG findings[3]
References
- ↑ Liu, Yu-Chun (2006). "Asymptomatic Metastasis of Hepatocellular Carcinoma into the Right Ventricular Cavity Presenting with electrocardiographic Changes" (PDF). Acta Cardiol Sin. 22: 180–183.
- ↑ Bernardi M, Maggioli C, Dibra V, Zaccherini G (2012). "QT interval prolongation in liver cirrhosis: innocent bystander or serious threat?". Expert Review of Gastroenterology & Hepatology. 6 (1): 57–66. doi:10.1586/egh.11.86. PMID 22149582. Retrieved 2012-09-06.
- ↑ 3.0 3.1 Madias JE (2007). "Attenuation of ECG voltage in cirrhotic patients". Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology. 9 (3): 175–81. doi:10.1093/europace/eul182. PMID 17344308. Retrieved 2012-09-06.
- ↑ http://europace.oxfordjournals.org/content/10/1/96.abstract