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EKG’de PR Çökmesi ve Elektriksel Alternans Perikardite mi Spesifiktir?

Year 2014, Volume: 5 Issue: 2, 53 - 56, 01.02.2014

Mücahit Kapçı Önder Tomruk Mehmet Gülcan Mücahit Avcil

Abstract

Giriş: Acil servise göğüs ağrısıyla başvuran genç hastalarda çekilen
elektrokardiyografide (EKG) görülen PR-segment çökmesi
ve elektriksel alternans genellikle perikarditi akla getirmektedir.
Buna rağmen pnömotorakslarda da perikardit eşlik etmeden
benzer EKG bulguları görülebilmektedir. Olgumuz, pnömotoraks
durumunda oluşabilecek EKG değişikliklerini hatırlatmak amacıyla
sunulmuştur.
Olgu Sunumu: Göğüs ağrısı ile acil servise başvuran erkek hastada
çekilen EKG’de sinüs taşikardisi, tüm derivasyonlarda elektriksel
alternans, inferior derivasyonlarda PR-segment çökmesi,
V5- V6 da R progresyon kaybı vardı. Göğüs ağrısı ayırıcı tanısı için
çekilen akciğer grafisinde sol hemitoraksta pnömotoraks tesbit
edildi. Pnömotoraksa yönelik sol orta aksiler hattan toraks tüpü
takıldı. Çekilen kontrol grafide pnömotoraks hattının kaybolduğu
ve kontrol EKG’sinde; taşikardi, PR-segment çökmesi ve elektriksel
alternansın düzeldiği görüldü.
Sonuç: Acil servise göğüs ağrısı ile başvuran hastalarda hayatı
tehdit eden kardiyak ve pulmoner acilleri tanımak ve EKG’lerini
erken görmek önemlidir. Bu amaçla çekilen EKG’de görülen
elektriksel alternans ve PR-segment çökmesi gibi bulgular genç
hastalarda daha çok perikarditi düşündürmektedir. Fakat özellikle
sol tarafta oluşan pnömotorakslarda da benzer bulgulara rastlanabilir.

Keywords

EKG değişikliği pnömotoraks perikardit

References

  • Niemann JT. The cardiomyopathies, myocarditis, and pericardial dise- ase. In Judith E. Tintinalli, MD. MS, Editor. Emergency Medicine. 6th ed. New York: Mc Graw-Hill; 2004.p.378-86.
  • Harper RJ. Pericardiocentesis. In James R Roberts, MD, Jerris R Hedges, MD, MS, Editors. Clinical Procedures in Emergency Medicine. Saunders, USA, 4th ed; 2004.p.305-22.
  • Soltani P, Malozzi CM, Abi Saleh B, Omar B. Electrocardiogram manifes- tation of spontaneous pneumothorax. Am J Emerg Med 2009; 27: 750. e1-5.
  • Strizik B, Forman R. New ECG changes associated with a tension pneu- mothorax: a case report. Chest 1999; 115: 1742-4. [CrossRef]
  • Kamimura M, Kudo K, Kubota T, School JM. ECG changes in tension pneumothorax: a hypothesis. Chest 2000; 117: 1527. [CrossRef]

Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?

Year 2014, Volume: 5 Issue: 2, 53 - 56, 01.02.2014

Mücahit Kapçı Önder Tomruk Mehmet Gülcan Mücahit Avcil

Abstract

Introduction: It is important to remember that pericarditis in young patients are associated with chest pain and accompanying electrocardiogram (ECG) signs, such as PR-segment depression and electrical alternans, in emergency departments. However, similar ECG changes may be found in patients with pneumothorax without pericarditis. The aim of this case study is to review the ECG changes of pneumothorax.Case Report: A male patient was admitted to our department with chest pain. The ECG examination showed sinus tachycardia, electrical alternans in all leads, PR-segment depression in inferior derivations, and loss of R progression in V5-V6. Chest X-ray radiography was taken for differential diagnosis, and it revealed pneumothorax in the left hemithorax. A chest tube was inserted on the left mid-axillar line. Control chest X-ray radiography revealed disappearance of the pneumothorax border. The control ECG showed that all changes were improved.Conclusion: Young patients with chest pain who are admitted to the emergency department should be evaluated for lifethreatening cardiac and pulmonary emergencies with early ECG examination. Electrical alternans, sinus tachycardia, and PR-segment depression are major signs in pericarditis. However, pneumothorax, especially occurring in the left hemithorax, may show similar findings

Keywords

ECG changes pneumothorax pericarditis

References

  • Niemann JT. The cardiomyopathies, myocarditis, and pericardial dise- ase. In Judith E. Tintinalli, MD. MS, Editor. Emergency Medicine. 6th ed. New York: Mc Graw-Hill; 2004.p.378-86.
  • Harper RJ. Pericardiocentesis. In James R Roberts, MD, Jerris R Hedges, MD, MS, Editors. Clinical Procedures in Emergency Medicine. Saunders, USA, 4th ed; 2004.p.305-22.
  • Soltani P, Malozzi CM, Abi Saleh B, Omar B. Electrocardiogram manifes- tation of spontaneous pneumothorax. Am J Emerg Med 2009; 27: 750. e1-5.
  • Strizik B, Forman R. New ECG changes associated with a tension pneu- mothorax: a case report. Chest 1999; 115: 1742-4. [CrossRef]
  • Kamimura M, Kudo K, Kubota T, School JM. ECG changes in tension pneumothorax: a hypothesis. Chest 2000; 117: 1527. [CrossRef]
There are 5 citations in total.

Details

Other ID JA82VD63CG
Journal Section Case Report
Authors

Mücahit Kapçı

Önder Tomruk This is me

Mehmet Gülcan This is me

Mücahit Avcil This is me

Publication Date February 1, 2014
Submission Date February 1, 2014
Published in Issue Year 2014 Volume: 5 Issue: 2

Cite

APA Kapçı, M., Tomruk, Ö., Gülcan, M., Avcil, M. (2014). Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?. Journal of Emergency Medicine Case Reports, 5(2), 53-56.
AMA Kapçı M, Tomruk Ö, Gülcan M, Avcil M. Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?. Journal of Emergency Medicine Case Reports. February 2014;5(2):53-56.
Chicago Kapçı, Mücahit, Önder Tomruk, Mehmet Gülcan, and Mücahit Avcil. “Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?”. Journal of Emergency Medicine Case Reports 5, no. 2 (February 2014): 53-56.
EndNote Kapçı M, Tomruk Ö, Gülcan M, Avcil M (February 1, 2014) Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?. Journal of Emergency Medicine Case Reports 5 2 53–56.
IEEE M. Kapçı, Ö. Tomruk, M. Gülcan, and M. Avcil, “Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?”, Journal of Emergency Medicine Case Reports, vol. 5, no. 2, pp. 53–56, 2014.
ISNAD Kapçı, Mücahit et al. “Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?”. Journal of Emergency Medicine Case Reports 5/2 (February 2014), 53-56.
JAMA Kapçı M, Tomruk Ö, Gülcan M, Avcil M. Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?. Journal of Emergency Medicine Case Reports. 2014;5:53–56.
MLA Kapçı, Mücahit et al. “Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?”. Journal of Emergency Medicine Case Reports, vol. 5, no. 2, 2014, pp. 53-56.
Vancouver Kapçı M, Tomruk Ö, Gülcan M, Avcil M. Is PR Depression and Electrical Alternans in the ECG Finding Specific to Pericarditis?. Journal of Emergency Medicine Case Reports. 2014;5(2):53-6.