ELECTROCARDIOGRAPHIC CHANGES IN ACUTE PULMONARY EMBOLISM WITH RIGHT HEART STRAIN AND IT'S ASSOCIATION WITH ADVERSE CLINICAL EVENTS

Authors

  • Tariq Hussain Khattak Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Azmat Khan Combined Military Hospital/ National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Imran Ahmed Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Javeria Kamran Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Hafsa Khalil Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Aysha Siddiqa Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Rehana Javaid Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

Keywords:

Pulmonary embolism, Right heart strain, Thrombolysis

Abstract

Objective: To determine the frequency of electrocardiographic changes in right heart strain RHS due to acute pulmonary embolism PE and its effect on mortality.

Study Design: Prospective cross-sectional study.

Place and Duration of Study: AFIC/NIHD Rawalpindi, from Dec 2015 to Jan 2018.

Material and Methods: 70 patients with acute pulmonary embolism were enrolled in this study. The primary outcome was right heart strain (RHS) on echocardiogram. The secondary outcome was mortality.

Results: Mean age was 50.16 ± 18.754 and male were 51 (72.9%). Thirty eight (54.28%) had right heart strain RHS on echocardiography. Mortality was 14 (20%). Provocating factors were identified in 34 (48.6%). Major contributing factors were high altitude in 11 (15.7%) and postoperative and malignancy cases in 7 (10%) each. ECG changes with significant association with RHS included: Tachycadia in 13 (34%) (p-value 0.013), S wave in
lead I in 12 (31.57%) (p-value 0.039), T wave inversion TWI in lead VI and lead V2 in 10 (26.31%) and TWI in lead VI to V3 in 8 (21.05%) (p-value 0.03). ECG changes with significant association with mortality included- Tachycardia ≥100 bpmin 7 (50%) (p-value 0.012), SIQ3T3 in 5 (35.71%) (p-value 0.022), S wave in lead I in 8 (57.14%) (p-value 0.001), TWI in leads V1 through V2 in 5 (35.71%) (p-value 0.054) and TWI in leads V1 through
V3 in 5 (35.71%) (p-value 0.013).

Conclusions: ECG can identify patients with RHS in acute PE and this in turn helps in identifying patients vulnerable to adverse clinical events.

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Published

30-03-2018

How to Cite

1.
Khattak TH, Khan MA, Ahmed I, Kamran J, Khalil H, Siddiqa A, et al. ELECTROCARDIOGRAPHIC CHANGES IN ACUTE PULMONARY EMBOLISM WITH RIGHT HEART STRAIN AND IT’S ASSOCIATION WITH ADVERSE CLINICAL EVENTS. Pak Armed Forces Med J [Internet]. 2018 Mar. 30 [cited 2024 May 28];68(Suppl-1):S28-33. Available from: https://pafmj.org/PAFMJ/article/view/3262

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