Cirrhosis electrocardiogram: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Cirrhosis}} | {{Cirrhosis}} | ||
{{CMG}} | {{CMG}} {{AE}} {{Cherry}} | ||
==Overview== | ==Overview== | ||
In a few patients with [[cirrhosis]], circulating toxins may cause the [[The electrocardiogram|ECG]] to show prolongation of the [[QT interval]]. Low voltage complexes in the [[Electrocardiogram|precordial leads]] may also be noticed in [[Patient|patients]] due to [[Hypervolemia|fluid overload]]. | |||
==Electrocardiogram== | ==Electrocardiogram== | ||
Abnormalities of cardiac electrophysiology | Abnormalities of [[cardiac electrophysiology]] may be noted in [[cirrhosis]]. The most common finding is [[QT prolongation|QT interval prolongation]]. | ||
;QT interval prolongation | ;QT interval prolongation <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 is a sign of cirrhotic cardiomyopathy. | * It is a sign of [[Cirrhosis|cirrhotic]] [[cardiomyopathy]]. | ||
* It | * It may be due to the following: | ||
* | ** Circulating [[Toxin|toxins]] in the blood stream | ||
* Stress due to | ** [[:Category:Drugs|Drugs]] | ||
** 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 voltages is noticed mainly in patients who have [[ascites]] and peripheral [[edema]] | |||
* 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 | |||
* [[diuretics|Diuretic]] use in case of [[Pedal edema|peripheral edema]] leads to improvement in ECG findings | |||
* [[paracentesis]] has no effect on [[The electrocardiogram|ECG]] findings<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 |month=March |pmid=17344308 |doi=10.1093/europace/eul182 |url=http://europace.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=17344308 |accessdate=2012-09-06}}</ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Gastroenterology]] | |||
[[Category:Hepatology]] | |||
[[Category:Disease]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]
Overview
In a few patients with cirrhosis, circulating toxins may cause the ECG to show prolongation of the QT interval. Low voltage complexes in the precordial leads may also be noticed in patients due to fluid overload.
Electrocardiogram
Abnormalities of cardiac electrophysiology may be noted in cirrhosis. The most common finding is QT interval prolongation.
- QT interval prolongation [1]
- It is a sign of cirrhotic cardiomyopathy.
- 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 [2]
- Attenuation of ECG voltages is noticed mainly in patients who have ascites and peripheral edema
- This finding may be corrected by placing leads cranially[3]
- 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[2]
References
- ↑ 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.
- ↑ 2.0 2.1 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