The provocative study by Stein et al
1
titled “Electrocardiogram in Pneumonia” merits additional clinical commentary. It
serves as a reverse review of the investigators' previous discussions of electrocardiographic
(ECG) findings in acute pulmonary embolism.
2
,
3
Unfortunately, the “clinical clouds” remain undissipated with regard to offering
assistance in using electrocardiography in the differential diagnosis between pneumonia
and pulmonary embolism. As indicated, the strength of the study is predominantly provided
by the formidable list of exclusion criteria. Its weakness includes the small number
of patients classified as having pneumonia and the lack of classification of subsets
of patients comparing age with the ECG abnormalities. This could perhaps indicate
the presence of undiagnosed heart disease, preferentially that of coronary artery
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References
- Electrocardiogram in pneumonia.Am J Cardiol. 2012; 110: 1836-1840
- The electrocardiogram in acute pulmonary embolism.Prog Cardiovasc Dis. 1975; 17: 247-257
- Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease.Chest. 1991; 100: 598-603
- The electrocardiogram in acute pulmonary embolism.Am Heart J. 1940; 19: 166-184
- The Urokinase Pulmonary Embolism Trial. A national cooperative study.Circulation. 1973; 47: 1-108
- Electrocardiographic abnormalities in patients with right ventricular dilation due to acute pulmonary embolism.Cardiology. 2006; 105: 57-60
Article Info
Publication History
Received:
January 28,
2013
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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- Electrocardiogram in PneumoniaAmerican Journal of CardiologyVol. 110Issue 12
- PreviewFindings on electrocardiogram may hint that pulmonary embolism (PE) is present when interpreted in the proper context and lead to definitive imaging tests. However, it would be useful to know if electrocardiographic (ECG) abnormalities also occur in patients with pneumonia and whether these are similar to ECG changes with PE. The purpose of this investigation was to determine ECG findings in patients with pneumonia. We retrospectively evaluated 62 adults discharged with a diagnosis of pneumonia who had no previous cardiopulmonary disease and had electrocardiogram obtained during hospitalization.
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- ReplyAmerican Journal of CardiologyVol. 111Issue 9
- PreviewWe appreciate the comments from the letter by Dr. Basil M. RuDusky. Regarding subsets of patients according to age, these are shown in Table 1. We were careful to exclude patients with coronary heart disease or any other cardiac or pulmonary abnormality, but we obviously could not exclude patients with subclinical disease.
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