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Query: UMLS:C0011570 (depression)
172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Electrocardiograms of 90 patients with arteriographically documented acute submassive or massive pulmonary embolism and no associated cardiac or pulmonary disease were studied. Patients were derived from the Urokinase-Pulmonary Embolism Trial National Cooperative Study. In massive embolism, the electrocardiogram was normal in 6 per cent (3 of 50) of patients. With submassive embolism, 23 per cent of patients (9 of 40) had a normal electrocardiogram. Since one or more of the traditional manifestations of acute cor pulmonale (S1Q3T3, right bundle branch block, P pulmonale, or right axis deviation) occurred in only 26 per cent of patients, one could not rely exclusively upon these electrocardiographic abnormalities for the diagnosis of pulmonary embolism. The most common electrocardiographic abnormalities were nonspecific T wave changes which occurred in 42 per cent of patients and nonspecific abnormalities (elevation or depression) of the RST segment which occurred in 41 per cent of patients. Left axis deviation occurring in 7 per cent of the patients was as frequent as right axis deviation. Low voltage QRS complexes, previously undescribed in pulmonary embolism, occurred in 6 per cent of patients. None of the patients had atrial flutter or atrial fibrillation, which appears to occur more typically in patients with pulmonary embolism who have preexistent cardiac disease. All of the varieties of electrocardiographic abnormalities disappeared in some of the patients by 2 wk. Inversion of the T wave was the most persistent abnormality. Larger defects on the lung scan or pulmonary arteriogram occurred in patients with various abnormalities on the electrocardiogram than in patients with normal electrocardiograms. The pulmonary arterial mean pressure and/or right ventricular end-diastolic pressure was significantly higher in patients with several varieties of abnormal electrocardiograms, although the partial pressure of oxygen in arterial blood, in general, did not differ from that in patients with normal electrocardiograms. These hemodynamic correlations, made for the first time in patients, suggest that acute ventricular dilatation, possibly in combination with hypoxemia, is a causative factor of the electrocardiographic changes in acute massive or submassive pulmonary embolism.
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PMID:The electrocardiogram in acute pulmonary embolism. 12 74

Ninety-eight cases of scrub typhus were examined electrocardiographically. Various findings beyond the normal range were as follows: In the febrile stage, sinus arrhythmia with some beats below 60 per minute, flat or low T waves in the left precordial leads, sinus tachycardia, ST segment elevation of 4-l mm in V2, prominent u waves measuring 1 mm or more in amplitude, tall and peaked T waves in V2-4, incomplete right bundle branch block, T wave inversion in V3-4, first degree A-V block, Q-Tc interval prolongation, notched T waves in V3, AV junctional escapes, prominent Ta waves or depression of PR segments in V2, and right axis deviation; in the convalescent stage, sinus arrhythmia with some beats below 60 per minute, prominent u waves measuring 1 mm or more in amplitude, tall and peaked T waves in V2-4, flat or low T waves in the left precordial leads, incomplete right bundle branch block, sinus tachycardia, first degree A-V block, Q-Tc interval prolongation, T wave inversion in V3-4, ST segment elevation of 4 mm in amplitude in V2, ventricular premature contractions, atrial premature contractions, and right axis deviation. In comparison with the electrocardiographic findings in 101 asymptomatic normal subjects, flat T waves in the precordial leads, tall and peaked T waves in V2-4 in both acute and convalescent stages, and sinus arrhythmia with some beats below 60 per minute in the convalescent stage were more frequent in cases. Electrocardiographic abnormalities were present most commonly in the acute illness, and our findings support the impression that, with few exceptions, prompt treatment of scrub typhus with antibiotics prevents the serious cardiac complications seen prior to the antibiotic era.
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PMID:Electrocardiographic changes in scrub typhus patients. 14 73

Exercise electrocardiography and selective coronary arteriography was performed in 24 consecutive patients with complete bundle branch block. The criteria for a positive exercise electrocardiogram (E-ECG) were a 1 mm depression or elevation in the J point from the control state, as well as in the ST-segment measured at 0.04 seconds from the J point. Eleven of 12 patients with complete left bundle branch block had a positive E-ECG. Nine of them had normal coronary arteriograms, except one with less than 50% lesions in two arteries. Two patients had severe three-vessel disease. Only one patient had a true negative exercise test. No patient had a false negative test. Nine of 12 patients with complete right bundle branch block had a positive E-ECG. One of these 9 had minimal nonobstructive disease, while the other 8 had severe two- or three-vessel coronary artery disease. Three of the 12 right bundle branch block patients had a negative E-ECG. Two of them had a true negative exercise test, and one a false negative test. Because of a high incidence of probably false positive results, E-ECG appears to be unreliable in detecting coronary artery disease in patients with complete left bundle branch block. But it can provide useful information in the noninvasive evaluation of coronary artery disease in patients with complete right bundle branch block.
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PMID:Value of treadmill exercise testing in patients with complete bundle branch block. 45 40

This study presents the results of maximal treadmill testing and cardiac catheterization in 40 asymptomatic and apparently healthy men with acquired right bundle-branch block. Eight of the men had significant angiographic coronary artery disease, and six of the eight only had single-vessel disease. The 40 men had normal maximal oxygen consumptions, normal maximal heart rates, and normal maximal blood pressure responses; none of the men had abnormal ST-segment changes in response to maximal treadmill testing. Thus, the sensitivity of exercise testing for coronary artery disease in men with right bundle branch block is uncertain. However, the apparently high specificity of exercise testing demonstrated by this study necessitates further evaluation for coronary artery disease in men with right bundle branch block who develop abnormal ST-segment depression in response to exercise testing.
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PMID:The electrocardiographic response to maximal treadmill exercise of asymptomatic men with right bundle branch block. 83 47

Right ventricular (RV) systolic time intervals and hemodynamic parameters were determined by micromanometric techniques in 13 subjects with normal right ventricles (NRV). These data were compared to those of 16 patients with pulmonary hypertension (PH) or predominant pressure overloading and 13 individuals with uncomplicated secundum atrial septal defects (ASD) or predominant volume overloading. In PH, the QP2 interval tends to remain within the normal range due to reciprocal changes in isovolumic contraction (ICT) and ejection (RVET) times. Elevations of pulmonary artery diastolic pressure are associated with increases in the mean rate of isovolumic pressure rise (MRIPR) (r = 0.84), but the latter change does not fully compensate for the widened ventriculoarterial diastolic pressure difference and ICT becomes prolonged (P less than 0.001). Factors other than stroke index depression which may contribute to the decreased duration of RVET (P less than 0.001) include tricuspid regurgitation and elevation of pulmonary vascular impedance. In ASD, QP2 is significantly prolonged (P less than 0.025) due to a significant increase in RVET (P less than 0.005). In contrast to NRV, a linear correlation of RVET and stroke index was not present, which suggested an alteration of ejection dynamics in this group. Despite a high incidence of complete or incomplete right bundle branch block the interval from QRS onset to rapid RV pressure upstroke was not prolonged. This is most probably the result of peripheral bundle branch block of genesis of the QRS pattern by right ventricular hypertrophy.
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PMID:Alterations of right ventricular systolic time intervals by chronic pressure and volume overloading. 126 38

In severe bronchial asthma reversible electrocardiographic abnormalities are not rare. It is usually sinus tachycardia, right axis deviation, atrial enlargement and right bundle branch block. Transient ST-segment depression or elevation in inferior leads in severe acute asthma has been observed since long. Adrenergic stimulation, hyperventilation, hyperinflation and primary or secondary coronary insufficiency were as a causes. Severity of ECG signs correlated with the degree of airway obstruction. Our study was aimed at investigation of electrocardiographic abnormalities in chronic pulmonary obstructive disease and asthma and to assess the relationship of the extent of airway obstruction to the frequency of ECG changes. Correlation was found of ECG manifestation of sinus tachycardia, right ventricle hypertrophy. ventricular premature complex, right bundle branch block with the degree of airway obstruction.
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PMID:[Electrocardiographic changes in patients with airway obstruction]. 138 34

The ECG is useful in diagnosing acute myocardial infarction and unrecognized Q-wave myocardial infarction in the elderly. Unrecognized myocardial infarction and myocardial infarction associated with clinical symptoms have a similar incidence of new coronary events. Ischemic ST-segment depression on the resting ECG is associated with an increased incidence of new coronary events. The ECG is useful in the diagnosis of LV hypertrophy but is less sensitive and less specific than echocardiography in diagnosing LV hypertrophy. ECG LV hypertrophy is associated with an increased incidence of cardiovascular events in the elderly. However, echocardiographic LV hypertrophy is more sensitive in predicting new coronary events, atherothrombotic brain infarction, and congestive heart failure than is ECG LV hypertrophy. The ECG is also useful in diagnosing conduction defects and arrhythmias in the elderly. In the elderly, left bundle branch block, intraventricular conduction defect, Type II second-degree atrioventricular block, and pacer rhythm are associated with an increased incidence of new cardiac events, whereas right bundle branch block, left anterior fascicular block, and first-degree atrioventricular block are not. In the elderly, atrial fibrillation is associated with an increased incidence of thromboembolic stroke and new cardiac events. Premature atrial complexes and paroxysmal supraventricular tachycardia are not associated with an increased cardiac risk. Complex ventricular arrhythmias on the resting ECG are associated with an increased incidence of cardiac events in elderly patients with heart disease but not in elderly patients without heart disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Usefulness of the resting electrocardiogram in the elderly. 147 52

The aim of this study was to evaluate the late potentials (LPs) in postoperative patients with congenital heart disease (CHD) and to study the association with the clinical characteristics in the postoperative patients with LPs. Signal averaged electrocardiogram (SA-ECG) was recorded in 119 postoperative patients aged 4 to 23 years and compared with those in age matched 49 healthy volunteers with and without right bundle branch block. Based on control data, criterias of LP were defined and altered in the presence of bundle branch block. Abnormal SA-ECGs were not detected in the patients with non-cyanotic CHD. However, abnormal and borderline SA-ECGs were recognized in 5 (12%) of 42 patients after intracardiac operation for tetralogy of Fallot and 3 (30%) of 9 patients after Rastelli's operation. The patients with abnormal and borderline SA-ECGs were significantly older at the time of operation, and had more frequent ventricular arrhythmias (7/8: 3/111, p less than 0.01) and depression of the ST-T segment on ECG (7/8: 11/111, p less than 0.01), compared with the normal SA-ECG group. Abnormal SA-ECGs including those of borderline patients were 50% sensitive and 96% specific for documented ventricular arrhythmias. However, there was no association between abnormalities of SA-ECGs and cardiomegaly on chest X-ray or left ventricular ejection fraction on echocardiogram. These results indicate that prolonged exposure to hypoxia may be the main cause of the primary role in the development of LPs. And late surgical intervention may result in histological background for the development of LPs.
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PMID:Clinical significance of late potentials in patients after intracardiac operation for congenital heart disease. 149 57

A geriatric study was conducted on 213 institutionalized geriatric glaucoma patients (mean age 83.9 years) and 100 control patients (mean age 81.3 years). A 12-lead electrocardiogram (ECG) analyzed according to the Minnesota code was recorded for 212 glaucoma patients and 95 control patients. The most frequent finding (in 56% of the glaucoma patients and in 38% of the control patients, P less than 0.05) was a negative or isoelectric T-wave, suggestive of ischemic heart disease. ECG findings suggestive of coronary heart disease (Q/QS patterns, ST-segment depression, negative or isoelectric T-wave, third or second degree AV block, left bundle branch block or right bundle branch block, intraventricular block or atrial fibrillation or flutter) was seen significantly more often in glaucoma patients (164/212; 77%) than in the control patients (59/95; 62%). Seventeen percent of the glaucoma patients had atrial fibrillation (AF), which was significantly more than for the control group (8/95; 8%). There was no difference in the number of ECG changes between patients with bilateral open-angle glaucoma and bilateral angle-closure glaucoma. The mean intraocular pressure of patients having AF (15.9 +/- 8 mmHg) was significantly lower than that of the other patients (18.4 +/- 11 mmHg) (P less than 0.05). Fifty-five glaucoma patients were considered blind (visual acuity less than 0.05 in the better eye). The visual acuity of patients having AF was lower than that of the other patients, and severe visual field defects (arcuate scotoma or a residual field in the temporal periphery) occurred, slightly more frequently in patients with AF (in 70% vs 51% of the other patients). Arrhythmias, especially AF, are connected with impairment of visual acuity and visual field defects in glaucoma patients. The result of this retrospective study indicate that ECG changes occur frequently, suggesting coronary heart disease in elderly glaucoma patients.
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PMID:Electrocardiographic changes in institutionalized geriatric glaucoma patients. 159 83

The new electrocardiographic criteria for diagnosing left ventricular hypertrophy (LVH) were evaluated in patients with complete right bundle branch block (CRBBB) based on the relationships between left ventricular mass and multiple electrocardiographic variables obtained from 12-lead electrocardiograms. The subjects consisted of 88 patients with CRBBB, whose ages ranged from 18 to 86 years. Patients with histories of myocardial infarction, moderate to severe pericardial effusion and an undetermined axis were excluded from the study. LVH was defined as left ventricular mass (LVmass) > or = 215 g calculated from the Penn method using standard M-mode echo measurements. All electrocardiograms were interpreted by one investigator who had no knowledge of the echocardiographic results. Items calculated were the amplitude of Q, R, and S waves and their A/R, R/S, and S/A ratios, the mean frontal QRS axis, ventricular activation time in lead V5, the Morris' index, ST-T segment depression in leads V5,6, and negative U waves in leads V5,6. We selected 22 items for our criteria according to their sensitivity and specificity, and added to the 11 previously reported ones determined. LV wall thickness correlated best with R I (r = 0.57, p < 0.01), LV diastolic dimension with RV5 (r = 0.48, p < 0.01), and LV mass with R I+S III (r = 0.60, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Electrocardiographic diagnosis of left ventricular hypertrophy accompanied by complete right bundle branch block]. 184 27


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