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[The electrocardiogram in endomyocardial fibrosis]
N M Tobias1, P J Moffa, C A Pastore
1Instituto do Coração, Hospital das Clínicas, FMUSP.
Insights
Electrocardiography can help identify ventricular involvement in endomyocardial fibrosis. Specific patterns like low voltage QRS or left anterior hemiblock correlate with right or left ventricular compromise, respectively.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Imaging
Context:
- Endomyocardial fibrosis (EMF) is a rare infiltrative cardiomyopathy.
- Diagnosis often relies on imaging, but electrocardiography (ECG) may offer clues.
- Understanding ECG patterns can aid in early detection and management.
Purpose:
- To describe common electrocardiographic findings in endomyocardial fibrosis.
- To correlate these ECG findings with the specific pattern of ventricular involvement.
Summary:
- This study analyzed 100 patients with EMF, categorizing them by ventricular compromise (right, left, or biventricular).
- Distinct ECG patterns were observed: low voltage QRS and right bundle branch block in right ventricular EMF, and left anterior hemiblock in left ventricular EMF.
- While nonspecific, ECG findings can suggest the extent and location of cardiac involvement in EMF.
Impact:
- ECG analysis can contribute to the non-invasive assessment of EMF.
- Identifying specific ventricular involvement through ECG may guide further diagnostic and therapeutic strategies.
- This research enhances the utility of standard ECG in diagnosing a rare cardiac condition.
Purpose:
To detail the most common electrocardiographic findings on the endomyocardial fibrosis and to correlate with the ventricular form.
Methods:
One hundred patients with endomyocardial fibrosis (68 female) with ages between 5 and 64 years old (mean 34 years). According to ventriculographic aspect the patients were divided in three groups: group I--11 patients with predominant right ventricular compromise; group II--58 patients with biventricular involvement, but not necessarily similar in intensity; group III--31 patients with predominant left ventricular compromise.
Results:
On patients with predominant right ventricular compromise, the electrocardiographic pattern was of QRS complex of low voltage in the frontal plane, presence of incomplete right bundle block and QRS complex with low voltage and with qr or qs aspect in V1 contrasting with QRS complex of great amplitude on V2 and V3. Left anterior hemiblock, aspect of inactive area, and R waves of high voltage on left precordial leads were observed on patients with predominant left ventricular involvement.
Conclusion:
The electrocardiogram of endomyocardial fibrosis, in spite of inespecific, may help in the identification of ventricular involvement.