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The Electrocardiogram in Pneumonia

      The provocative study by Stein et al
      • Stein P.D.
      • Matta F.
      • Ekkah M.
      • Saleh T.
      • Janjua M.
      • Patel Y.
      • Khadra H.
      Electrocardiogram in pneumonia.
      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.
      • Stein P.D.
      • Dalen J.E.
      • McIntryre K.M.
      • Sasahara A.A.
      • Wenger N.K.
      • Willis P.W.
      The electrocardiogram in acute pulmonary embolism.
      • Stein P.D.
      • Terrin M.L.
      • Hales C.A.
      • Palevsky H.I.
      • Saltzman H.A.
      • Tompson B.T.
      • Weg J.G.
      Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease.
      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 disease.
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      References

        • Stein P.D.
        • Matta F.
        • Ekkah M.
        • Saleh T.
        • Janjua M.
        • Patel Y.
        • Khadra H.
        Electrocardiogram in pneumonia.
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        • Dalen J.E.
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      Linked Article

      • Electrocardiogram in Pneumonia
        American Journal of CardiologyVol. 110Issue 12
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          Findings 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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      • Reply
        American Journal of CardiologyVol. 111Issue 9
        • Preview
          We 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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