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Left atrial enlargement: an electrocardiographic misnomer? An electrocardiographic-echocardiographic study

I van Dam, J Roelandt, E O Robles de Medina

    European Heart Journal
    |February 1, 1986
    PubMed

    Insights

    Electrocardiography (ECG) and echocardiography show poor agreement for diagnosing left atrial enlargement. Echocardiography is a more reliable method for assessing left atrial size in cardiac patients.

    Area of Science:

    • Cardiology
    • Medical Imaging

    Background:

    • Left atrial enlargement is a significant indicator of cardiac disease.
    • Electrocardiography (ECG) and echocardiography are common diagnostic tools for cardiac conditions.

    Purpose of the Study:

    • To evaluate the agreement between ECG and echocardiography in diagnosing left atrial enlargement.
    • To determine the reliability of each method for assessing left atrial size.

    Main Methods:

    • A study was conducted on 100 adult patients with diverse cardiac conditions.
    • Electrocardiography and echocardiography were used to diagnose left atrial enlargement.
    • Analysis focused on agreement rates and discrepancies between the two diagnostic methods.

    Main Results:

    • There was a significant lack of agreement between ECG and echocardiography for diagnosing left atrial enlargement, with agreement in only 4 out of 100 patients.
    • ECG P-wave analysis was not possible in 19 patients due to arrhythmias, yet 13 of these showed left atrial enlargement on echocardiography.
    • Of the remaining 81 patients, only 4 met ECG criteria for enlargement, while 20 showed enlargement on echocardiography.

    Conclusions:

    • Electrocardiography and echocardiography demonstrate poor concordance in diagnosing left atrial enlargement.
    • Echocardiography is suggested as the reference standard for accurately measuring left atrial size.

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