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Dilated Cardiomyopathy
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Marco Merlo, Alessia Paldino, Giulia De Angelis, Gianfranco Sinagra
Although DCM is not typically characterized by specific ECG findings, a careful analysis can provide several clues about the etiology as well as the duration of the disease. For example, dystrophin-related DCM is generally characterized by a “posterolateral pseudonecrosis” aspect, atrioventricular blocks can suggest a mutation in LMNA, and myotonic dystrophy and Emery Dreifuss disease can be associated with sinus bradycardia and atrial standstill.17 Left atrial enlargement is frequent in DCM and is usually an expression of a long-standing disease.48 Left bundle-branch block is usually a marker of long-standing disease with prognostic and therapeutic implications.49,50 In general, the ECG is important prognostically. Antero-lateral T-wave inversion, low QRS voltages, and fragmented QRS have been reported as independent predictors of death, heart transplantation, SCD, and malignant ventricular arrhythmias in a cohort of 414 patient with DCM.51,52
The Phrenic Nerves, Diaphragm and Pericardium.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Other causes of recurrent laryngeal nerve palsy include: Aortic aneurysm (luetic used to be common, but is now rarely encountered); traumatic and dissecting aneurysms may causes a left recurrent laryngeal palsy. Left atrial enlargement and pericardial effusions are often listed as causes, but have not been encountered by the author.
Heart failure
Published in Henry J. Woodford, Essential Geriatrics, 2022
Transthoracic echocardiography is recommended for people with a new diagnosis of heart failure. Its functions include the ability to identify any valvular lesions and estimate EF. HFpEF is associated with left ventricular hypertrophy, but not dilatation. Although, left ventricular mass can appear normal on echocardiography.7 There is likely to be left atrial enlargement. Standard techniques for estimating EF tend to overestimate its value in the presence of left ventricular enlargement (and associated change in shape). Echocardiography is also able to distinguish constrictive pericarditis from diastolic dysfunction.
Influence of relative wall thickness on electrocardiographic voltage measures in left ventricular hypertrophy: a novel factor contributing to poor diagnostic accuracy
Published in Postgraduate Medicine, 2020
Ning Ye, Guo-Zhe Sun, Ying Zhou, Shao-Jun Wu, Ying-Xian Sun
A recent study [8] demonstrated that isolated left atrial dilation has indeterminately moderate effects on P-wave duration and voltage. In contrast, left atrial concentric hypertrophy consistently increased P-wave amplitude, with duration unaffected. These findings provided a potential explanation regarding the limited utility of current P-wave criteria in the detection and diagnosis of left atrial enlargement in clinical practice. However, insufficient data have been reported in relation to the independent influence of left ventricular geometry on ECG voltage for ascertaining LVH. A general consensus has been established regarding the use of echocardiographic relative wall thickness (RWT) when defining concentric and eccentric changes [9]. Hence, we subsequently proposed an original hypothesis suggesting that RWT itself could potentially influence the diagnostic performance of ECG indices by affecting QRS voltages, independent of the left ventricular mass index (LVMI). The influence of RWT on Cornell, Sokolow-Lyon and Peguero-Lo Presti voltage were examined, after which the effects identified were evaluated in regard to the diagnostic performance in detecting LVH in a large general Chinese population.
High-Detailed evaluation of the right atrial anatomy by three-dimensional rotational angiography during ablation procedures for atrioventricular nodal reentrant tachycardia and atrial flutter
Published in Scandinavian Cardiovascular Journal, 2018
Christophe Garweg, Stijn De Buck, Bert Vandenberk, Rik Willems, Joris Ector
The underlying mechanism contributing to RA enlargement remains to be determined. According to our criteria of patient exclusion for the study, it cannot be related to pulmonary hypertension, chronic lung disease, valve and organic heart disease. Our results suggest that RA anatomical remodeling appears very early in the arrhythmic disease process since only 18% of our patients had experienced paroxysmal atrial fibrillation at the time of AVNRT or AFl ablation. The chronology of right and left atrial enlargement and their relative prognostic values in AF occurrence remain to be investigated. The combination of changes in RA volume with LA parameters may allow more accurate identification of patients at risk for AF.
Electrocardiographic and echocardiographic features in patients with major arterial vascular disease assigned to surgical revascularization
Published in Acta Cardiologica, 2019
Dimitri Tsialtas, Maria Giulia Bolognesi, Stephania Assimopoulos, Riccardo Volpi, Roberto Bolognesi
In each group, there was at least one type of valvular disease present. In particular, about a quarter of patients had mitral regurgitation, a tenth had aortic stenosis or regurgitation, while tricuspid regurgitation was scarcely present amongst the groups. Severe valvular diseases were independently associated with one year or long-term mortality in patients undergoing endovascular AAA repair [28,33]. Finally, almost a third of patients in each group exhibited left atrial enlargement. There is strong evidence that left atrial enlargement, as determined by echocardiography, is a robust predictor of cardiovascular events, as well as, of overall outcomes [34].