Cirrhosis electrocardiogram: Difference between revisions

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==Overview==
==Overview==
In a few patients with cirrhosis and has circulating toxins, and ECG may show prolongation of the QT interval. Low voltage complexes in the precordial leads can also be noticed in patients with fluid overload.
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 are noted in cirrhosis. The most common finding is QT interval prolongation.
Abnormalities of [[cardiac electrophysiology]] may be noted in [[cirrhosis]]. The most common finding is [[QT 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 |month=February |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>
;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 can be due to the circulating toxins in the blood stream.
* It may be due to the following:
* It may be due to drugs used in the treatment of cirrhosis.
** Circulating [[Toxin|toxins]] in the blood stream
* It can be caused by stress due to [[hemorrhage]], [[shock]] or surgery(transplantation)
** [[: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 |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>
;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.
* Attenuation of ECG voltages is noticed mainly in patients who have [[ascites]] and peripheral [[edema]]
* This finding can be corrected by placing leads 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 can be strongly corelated with this finding; diuretics for peripheral edema have shown improvement in the findings where as paracentesis didn't had any effect.<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>
* [[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]]
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Latest revision as of 10:30, 13 December 2017

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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]
Attenuation of ECG voltage [2]

References

  1. 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. 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.
  3. http://europace.oxfordjournals.org/content/10/1/96.abstract

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