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Electrocardiographic changes in hospitalized patients with leptospirosis over a 10-year period.

Škerk V, Markotić A, Puljiz I, Kuzman I, Čeljuska Tošev E, Habuš J, Turk N, Begovac J - Med. Sci. Monit. (2011)

Bottom Line: Abnormal ECG findings were found in 56 of 97 (58%) patients.Patients with abnormal ECG had significantly elevated values of bilirubin and alanine aminotransferase, lower values of potassium and lower number of platelets, as well as more frequently recorded abnormal chest x-ray.The ECG abnormalities are common at the beginning of disease and are possibly caused by the direct effect of leptospires or are the non-specific result of a febrile infection and metabolic and electrolyte abnormalities.

View Article: PubMed Central - PubMed

Affiliation: Clinical Hospital Centre Zagreb, Sestre Milosrdnice University Hospital, Clinic of Internal Medicine, Zagreb, Croatia. bfm@bfm.hr

ABSTRACT

Background: The aim of this study was to investigate the incidence and type of ECG changes in patients with leptospirosis regardless of clinical evidence of cardiac involvement.

Material/methods: A total of 97 patients with serologically confirmed leptospirosis treated at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević" in Zagreb, Croatia, were included in this retrospective study. A 12-lead resting ECG was routinely performed in the first 2 days after hospital admission. Thorough past and current medical history was obtained, and careful physical examination and laboratory tests were performed.

Results: Abnormal ECG findings were found in 56 of 97 (58%) patients. Patients with abnormal ECG had significantly elevated values of bilirubin and alanine aminotransferase, lower values of potassium and lower number of platelets, as well as more frequently recorded abnormal chest x-ray. Non-specific ventricular repolarization disturbances were the most common abnormal ECG finding. Other recorded ECG abnormalities were sinus tachycardia, right branch conduction disturbances, low voltage of the QRS complex in standard limb leads, supraventricular and ventricular extrasystoles, intraventricular conduction disturbances, atrioventricular block first-degree and atrial fibrillation. Myopericarditis was identified in 4 patients. Regardless of ECG changes, the most commonly detected infection was with Leptospira interrogans serovar Australis, Leptospira interrogans serovar Saxkoebing and Leptospira kirschneri serovar Grippotyphosa.

Conclusions: The ECG abnormalities are common at the beginning of disease and are possibly caused by the direct effect of leptospires or are the non-specific result of a febrile infection and metabolic and electrolyte abnormalities. New studies are required for better understanding of the mechanism of ECG alterations in leptospirosis.

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ECG finding: sinus tachycardia (114/min.) with non-specific ventricular repolarization disturbances (inversion of T wave in many leads – II, III, aVF standard limb leads and V1–V6 precordial leads. Artefact in V1 leads).
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f1-medscimonit-17-7-cr369: ECG finding: sinus tachycardia (114/min.) with non-specific ventricular repolarization disturbances (inversion of T wave in many leads – II, III, aVF standard limb leads and V1–V6 precordial leads. Artefact in V1 leads).

Mentions: ECG was recorded in all patients in the first 2 days after hospitalization when patients were febrile. Non-specific ventricular repolarization disturbances were the most common abnormal ECG finding (Figure 1). Other recorded ECG abnormalities were sinus tachycardia, right branch conduction disturbances, low voltage of the QRS complex in standard limb leads, supraventricular and ventricular extrasystoles, intraventricular conduction disturbances, atrioventricular block first-degree and atrial fibrillation. Myopericarditis was identified in 4 patients on the basis of physician examination (muffled first heart sound), ECG findings (non-specific ST segment and T wave abnormalities, tachycardia, arrhythmias) and echocardiography (Table 3).


Electrocardiographic changes in hospitalized patients with leptospirosis over a 10-year period.

Škerk V, Markotić A, Puljiz I, Kuzman I, Čeljuska Tošev E, Habuš J, Turk N, Begovac J - Med. Sci. Monit. (2011)

ECG finding: sinus tachycardia (114/min.) with non-specific ventricular repolarization disturbances (inversion of T wave in many leads – II, III, aVF standard limb leads and V1–V6 precordial leads. Artefact in V1 leads).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539558&req=5

f1-medscimonit-17-7-cr369: ECG finding: sinus tachycardia (114/min.) with non-specific ventricular repolarization disturbances (inversion of T wave in many leads – II, III, aVF standard limb leads and V1–V6 precordial leads. Artefact in V1 leads).
Mentions: ECG was recorded in all patients in the first 2 days after hospitalization when patients were febrile. Non-specific ventricular repolarization disturbances were the most common abnormal ECG finding (Figure 1). Other recorded ECG abnormalities were sinus tachycardia, right branch conduction disturbances, low voltage of the QRS complex in standard limb leads, supraventricular and ventricular extrasystoles, intraventricular conduction disturbances, atrioventricular block first-degree and atrial fibrillation. Myopericarditis was identified in 4 patients on the basis of physician examination (muffled first heart sound), ECG findings (non-specific ST segment and T wave abnormalities, tachycardia, arrhythmias) and echocardiography (Table 3).

Bottom Line: Abnormal ECG findings were found in 56 of 97 (58%) patients.Patients with abnormal ECG had significantly elevated values of bilirubin and alanine aminotransferase, lower values of potassium and lower number of platelets, as well as more frequently recorded abnormal chest x-ray.The ECG abnormalities are common at the beginning of disease and are possibly caused by the direct effect of leptospires or are the non-specific result of a febrile infection and metabolic and electrolyte abnormalities.

View Article: PubMed Central - PubMed

Affiliation: Clinical Hospital Centre Zagreb, Sestre Milosrdnice University Hospital, Clinic of Internal Medicine, Zagreb, Croatia. bfm@bfm.hr

ABSTRACT

Background: The aim of this study was to investigate the incidence and type of ECG changes in patients with leptospirosis regardless of clinical evidence of cardiac involvement.

Material/methods: A total of 97 patients with serologically confirmed leptospirosis treated at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević" in Zagreb, Croatia, were included in this retrospective study. A 12-lead resting ECG was routinely performed in the first 2 days after hospital admission. Thorough past and current medical history was obtained, and careful physical examination and laboratory tests were performed.

Results: Abnormal ECG findings were found in 56 of 97 (58%) patients. Patients with abnormal ECG had significantly elevated values of bilirubin and alanine aminotransferase, lower values of potassium and lower number of platelets, as well as more frequently recorded abnormal chest x-ray. Non-specific ventricular repolarization disturbances were the most common abnormal ECG finding. Other recorded ECG abnormalities were sinus tachycardia, right branch conduction disturbances, low voltage of the QRS complex in standard limb leads, supraventricular and ventricular extrasystoles, intraventricular conduction disturbances, atrioventricular block first-degree and atrial fibrillation. Myopericarditis was identified in 4 patients. Regardless of ECG changes, the most commonly detected infection was with Leptospira interrogans serovar Australis, Leptospira interrogans serovar Saxkoebing and Leptospira kirschneri serovar Grippotyphosa.

Conclusions: The ECG abnormalities are common at the beginning of disease and are possibly caused by the direct effect of leptospires or are the non-specific result of a febrile infection and metabolic and electrolyte abnormalities. New studies are required for better understanding of the mechanism of ECG alterations in leptospirosis.

Show MeSH
Related in: MedlinePlus