Twelve-lead electrocardiography in tuberculous pericarditis

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dc.contributor.authorSmedema J.P.
dc.contributor.authorKatjitae I.
dc.contributor.authorReuter H.
dc.contributor.authorBurgess L.
dc.contributor.authorLouw V.
dc.contributor.authorPretorius M.
dc.contributor.authorDoubell A.F.
dc.date.accessioned2011-05-15T16:15:55Z
dc.date.available2011-05-15T16:15:55Z
dc.date.issued2001
dc.description.abstractObjectives. This study is part of an ongoing initiative started in 1995 to investigate the therapeutic efficacy of adjuvant corticosteroids in the management of tuberculosis (TB) pericarditis. In this retrospective, descriptive study we describe the changes found on the 12-lead electrocardiogram (ECG) in patients with TB pericarditis, with and without cardiac tamponade. We determined the diagnostic accuracy of ECG parameters for cardiac tamponade. Methods. All patients referred to our department with echocardiographically confirmed large pericardial effusions underwent a thorough clinical assessment followed by pericardiocentesis and drainage using an indwelling pigtail catheter. The amount of drained effusion was measured, and fluid was sent for diagnostic assessment. Patients were grouped into those with or without cardiac tamponade. The following ECG parameters were assessed: rate, rhythm, microvoltage, electrical alternans, PR segment and ST segment abnormalities. Results. Of the 157 patients assessed, 88 were diagnosed with TB pericarditis. All had abnormal ECGs and 83% had changes of chronic pericarditis. Microvoltage in the extremity and/or precordial leads Correlated with the presence of large effusions (> 750 ml). None of the studied parameters correlated with the presence of cardiac tamponade. Conclusions. Twelve-lead ECG is of supportive but not diagnostic value in cardiac tamponade. The presence of microvoltage suggests the presence of a large effusion. The absence of microvoltage makes the presence of cardiac tamponade unlikely.
dc.description.versionArticle
dc.identifier.citationCardiovascular Journal of South Africa
dc.identifier.citation12
dc.identifier.citation1
dc.identifier.issn10159657
dc.identifier.urihttp://hdl.handle.net/10019.1/13552
dc.subjectadult
dc.subjectaged
dc.subjectarticle
dc.subjectdiagnostic accuracy
dc.subjectelectrocardiography
dc.subjectfemale
dc.subjectheart tamponade
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectpericardial effusion
dc.subjectpericardiocentesis
dc.subjectpericarditis
dc.subjectPR interval
dc.subjectrisk benefit analysis
dc.subjectthorax radiography
dc.subjecttuberculosis
dc.subjectCardiac Tamponade
dc.subjectDiagnostic Techniques, Cardiovascular
dc.subjectElectrocardiography
dc.subjectHumans
dc.subjectPericarditis, Tuberculous
dc.subjectPredictive Value of Tests
dc.subjectRetrospective Studies
dc.subjectSensitivity and Specificity
dc.titleTwelve-lead electrocardiography in tuberculous pericarditis
dc.typeArticle
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