Pulmonary edema electrocardiography

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]

Overview

Although there is no diagnostic criteria of pulmonary edema on the EKG, there may be signs of the underlying cardiogenic cause of pulmonary edema.

Electrocardiography

An ECG may be helpful in the diagnosis of cardiogenic pulmonary edema. Electrocardiography of patients with pulmonary edema is based on underlying cause:

• Left ventricular failure
  • Low QRS Voltage
  • Poor R wave progression
  • Left bundle branch block (LBBB)
  • Non-specific ST segment and T wave changes

• Dysrhythmia
  • For more information about dysrhythmia click here

• Left ventricular hypertrophy
  • The Sokolow and Lyon criteria
    • S in V1 + R in V5 or V6 (whichever is larger) ≥ 35 mm
    • R in aVL ≥ 11 mm
  • The Cornell criteria for the EKG diagnosis of LVH involves measurement of the sum of the R wave in lead aVL and the S wave in lead V3. The Cornell criteria for LVH are:
    • S in V3 + R in aVL > 28 mm (men)
    • S in V3 + R in aVL > 20 mm (women)

• Myocardial Infarction
  • For more information about myocardial infarction electrocardiography click here.