CLINICAL STUDY
clinical correlates of pr-segment depression in asymptomatic patients with pericardial effusion
Yoshihiro Kudo, MD*,*,
Fumiyasu Yamasaki, MD*,
Yoshinori Doi, MD and
Tetsuro Sugiura, MD*
* Clinical Laboratory MedicineKochi, Japan
Department ofGeriatric Medicine, Kochi Medical School, Kochi, Japan
Manuscript received November 6, 2001;
revised manuscript received March 5, 2002,
accepted March 27, 2002.
* Reprint requests and correspondence: Dr. Yoshihiro Kudo, Department of Clinical Laboratory Medicine, Kochi Medical School, Kohasu Oko-cho Nankoku City, Kochi, Japan 783-8505. kudohy{at}med.kochi-ms.ac.jp
OBJECTIVES: The purpose of this study was to determine the clinical correlates of PR-segment depression among consecutive asymptomatic patients with pericardial effusion (PE) detected by routine echocardiography.
BACKGROUND: Pericardial effusion is a relatively common finding in clinical practice, but not many studies have evaluated electrocardiographic (ECG) changes associated with the occurrence of PE.
METHODS: Among 4,061 consecutive patients referred to our echocardiography laboratory, 176 asymptomatic patients had PE correlated with their clinical history and ECG findings.
RESULTS: PR-segment depression was detected in 40 patients (23%). There were no significant differences in age, gender distribution or heart rate between patients with and without PR-segment depression. Fifteen post-pericardiotomy patients (33%), 19 patients (40%) with malignant disease and 6 patients (46%) with connective tissue disease had PR-segment depression, whereas no patient with heart disease (dilated cardiomyopathy, hypertensive heart disease, old myocardial infarction, valvular heart disease), renal disease or hypothyroidism had PR-segment depression, nor widespread ST-segment elevation. Among 40 patients with PR-segment depression, 8 had ST-segment elevation in the leads of epicardial derivation, 8 had upright T waves, 20 had low to inverted T waves with an isoelectric ST-segment and 4 had ST-Twave changes due to bundle branch block.
CONCLUSIONS: PR-segment depression was a relatively common ECG sign associated with clinically silent PE, and it was an ECG indicator of inflammatory pericardial involvement.
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Abbreviations and Acronyms
| | ECG = electrocardiogram/electrocardiographic | | LV = left ventricular | | MI = myocardial infarction | | PE = pericardial effusion |
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[Abstract]
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