Electrocardiogram in patients with pulmonary hypertension

Area of Science:

• Cardiology
• Medical Diagnostics

Background:

• Pulmonary hypertension (PH) is a severe cardiovascular disease often diagnosed late due to nonspecific symptoms.
• Early detection of PH is crucial for preventing further right heart strain and improving patient outcomes.
• Electrocardiography (ECG) is a non-invasive tool that may reveal characteristic signs of PH.

Purpose of the Study:

• To review the typical electrocardiographic patterns associated with pulmonary hypertension.
• To highlight the potential role of ECG in the earlier detection of PH.

Main Methods:

• A non-systematic literature review was conducted.
• The review focused on identifying characteristic ECG patterns in patients with PH.

Main Results:

• Characteristic ECG findings in PH include right axis deviation, specific limb lead patterns (SIQIIITIII, SISIISIII), P pulmonale, and right bundle branch block.
• Other common signs include deep R waves in anterior leads, deep S waves in lateral leads, and criteria for right ventricular hypertrophy.
• Repolarization abnormalities (ST depression, T-wave inversion), prolonged QT intervals, increased heart rate, and arrhythmias can also be present.

Conclusions:

• ECG signs are not universally present in all PH patients, especially those with mild disease, and cannot rule out PH alone.
• However, ECG provides valuable clues for PH diagnosis when clinical symptoms are present.
• The combination of typical ECG findings with clinical symptoms and elevated biomarkers like BNP strongly suggests PH, facilitating earlier diagnosis and intervention.