ecg cardiac tamponade

ECG cardiac tamponade is a rare complication of pericarditis. It is characterized by a low voltage ECG (<5 mm) with poor R-wave progression, together with ST elevation in the anterior leads (V1 and V2). The changes are similar to those seen in pericardial effusion, but ECG cardiac tamponade has distinct features that distinguish it from pericardial effusion:

There is no evidence of fluid around the heart on echocardiography.

There are no signs of heart failure, such as a raised jugular venous pressure or pulmonary congestion on the chest X-ray.

ecg cardiac tamponade

  1. T wave inversion in precordial leads V2-V4
  2. ST elevation in the same leads (usually not as great as in infarction)
  3. Q waves in lead III and aVF
  4. Deep S waves in leads I, II and V1 (the deep S wave is actually a negative deflection)

ECG of cardiac tamponade

ECG of cardiac tamponade. Notice the large P wave in lead II. There is also some elevation of the ST segments and a prolonged QT interval. This ECG was taken from a patient with a pericardial effusion and is therefore referred to as ‘wet’.

It is an ECG finding that has been associated with tamponade.

ECG findings of cardiac tamponade include:

  1. Widened QRS complexes on the electrocardiogram (ECG) with a dominant R wave in lead V1 (the patient’s right arm is placed on the left side, so V1 is the first lead on the right side of the body)
  2. Low voltage QRS complexes
  3. Loss of P waves (pulmonary embolism may also have loss of P waves)

Does cardiac tamponade show on ECG?

The ECG is not a good test for cardiac tamponade.

Cardiac tamponade is a disorder caused by the collection of blood in the pericardial space (the space between the heart and the parietal pericardium). It leads to limited filling of the heart and produces clinical signs and symptoms, including hypotension, tachycardia, distant heart sounds, muffled heart sounds and shock.

The ECG is not a good test for cardiac tamponade. Some patients with cardiac tamponade have normal ECGs (i.e., they do not show any abnormalities). In other patients, there are some subtle changes on their ECGs that may be difficult to interpret.

Cardiac tamponade is a medical condition in which blood or other fluid builds up within the pericardial sac, resulting in compression of the heart and diminished cardiac output. Cardiac tamponade is often accompanied by distended neck veins, dyspnea and hypotension.

There are no specific ECG changes associated with cardiac tamponade. However, there may be evidence of increased venous pressure (due to truncal obesity or peripheral edema), pulmonary congestion (due to pulmonary embolism or congestive heart failure) or hyperkalemia (with severe arrhythmias).

There may be ST-segment elevation in leads with reciprocal ST depression in leads without Q waves (i.e., ST elevation MI) due to myocardial ischemia from an abnormal coronary artery flow pattern caused by LV dysfunction from hypoperfusion due to systemic hypotension and/or hypovolemia causing reduced coronary perfusion pressure during diastole causing reperfusion injury during systole.

The inability to beat quickly enough can lead to death if not treated immediately by physicians who are trained in treating this condition.

Cardiac tamponade is a life-threatening condition in which fluid builds up in the sac surrounding the heart. This causes the heart to work harder to pump blood and can lead to shock, heart failure and death.

The symptoms of cardiac tamponade include shortness of breath, chest pain or discomfort, fainting and dizziness. The patient may also experience swelling in the legs and abdomen, which may be accompanied by nausea and vomiting.

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Electrocardiogram (ECG) test results are often normal in cases of cardiac tamponade because the electrical activity of the heart does not reflect the extent of its damage or dysfunction. However, ECG results may show changes if there is a large amount of fluid around the heart.

If the pericardial effusion is large enough, it can compress the heart and prevent it from filling with blood. Because of this, the ECG may show a low voltage (small heart), or no P waves at all.

If the pericardial effusion is small, however, there may not be any changes on the ECG.

What are the 3 classic symptoms of cardiac tamponade?

What are the 3 classic symptoms of cardiac tamponade
What are the 3 classic symptoms of cardiac tamponade?

Cardiac tamponade is the buildup of fluid in the pericardial sac surrounding the heart. The fluid presses on the heart and interferes with its ability to contract. This can lead to a drop in blood pressure, shock and even death if left untreated.

The classic symptoms of cardiac tamponade include:

Abdominal distention (enlargement) due to fluid pressing on your diaphragm. This may be seen as a bloated appearance or abdominal swelling.

Shortness of breath due to fluid pressing on your lungs.

Dullness to percussion (a dull sound) over the precordium (the area between your nipples).

Cardiac tamponade is a life-threatening condition in which blood or fluid builds up inside the pericardial sac. The pericardium is the membrane that surrounds the heart. The fluid can compress the heart, making it harder for it to pump blood.

The main symptoms of cardiac tamponade are:

Shortness of breath

Swelling of the legs, chest and neck (called peripheral edema)

Fast heartbeat (tachycardia)

What are alternans in ECG?

Alternans is a flaw in the heart’s electrical system that causes the heart rate to speed up and slow down rhythmically. This can be seen in an electrocardiogram (ECG).

Alternans may occur when there is an imbalance between the two sides of the heart, which is often associated with heart failure or cardiomyopathy. Alternans can also be caused by other conditions, such as electrolyte imbalances or poisoning with digitalis.

The ECG shows alternans when it records a change in the size of a waveform at each beat. This can be seen as a variation in the height and/or width of the P-waves or QRS complexes — the peaks and troughs that make up each individual heartbeat — on an ECG tracing.

Alternans are alternating beats of the heart, where one beat is normal and the next beat is abnormal.

Alternans can be seen in the electrocardiogram (ECG), which is a recording of the electrical activity of the heart. Alternans may occur in patients with heart failure, or when there is a blockage in a coronary artery.

Alternans can also be seen on an echocardiogram (ECHO), which uses sound waves to produce an image of the heart.

Alternans are changes in the amplitude of the QRS complex that occur in a regular pattern. The amplitude alternates between normal and increased (or decreased) amplitudes with each beat. Alternans may be seen in various cardiac conditions, such as heart failure, pericarditis, myocarditis, cardiomyopathy, coronary artery disease and others.

Alternans is sometimes referred to as “alternating T-wave amplitude” or “alternating T-wave sign”, but this term is imprecise because it includes other causes of alternating T-wave amplitude (such as early repolarization).

Alternans can be seen on the electrocardiogram (ECG) in many conditions of abnormal ventricular excitability including:

Heart failure


Myocarditis (inflammation of the heart muscle)

Cardiomyopathy (heart muscle problem)

What are the three signs of Beck’s triad?

Beck’s triad is a set of three signs that indicate a patient is at risk for developing pulmonary edema.

The signs are:

acute respiratory distress syndrome (ARDS)

altered mental state


Beck’s triad is a constellation of three clinical features:

Sudden death. This may be more common in children than adults.

Pneumonitis and pleural effusion. This may be asymptomatic or cause non-productive cough and chest pain for weeks to months prior to diagnosis.

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Myocarditis, often with conduction defects such as first degree heart block and Wenckebach sequence.

What is meaning of Beck’s triad?

What is meaning of Beck's triad
What is meaning of Beck’s triad

Beck’s triad is a medical term that refers to three conditions that can cause confusion in older adults:

atrial fibrillation, which is an irregular heartbeat;

subdural hematoma (bleeding on the brain), which occurs when blood collects between the skull and the brain; and

myasthenia gravis, which causes muscle weakness.

Beck’s Triad is a medical term used to describe three abnormalities associated with kidney stones: hematuria, proteinuria, and renal colic. The triad is named after its discoverer, Sir David Edward Beck (1887–1974), a physician who first described it in 1924.

The triad consists of hematuria (blood in the urine), proteinuria (protein in the urine) and renal colic (pain in the kidney). Hematuria and proteinuria indicate an increased risk of developing renal disease. Renal colic indicates possible stone formation in the kidney or ureter.

Beck’s triad is a set of three physiological findings commonly seen in patients with chronic alcohol abuse. It is named after the pioneer in alcoholism research, Dr. E. M. Beck, who first described it in 1965.

The three findings are:

1) Bradycardia (a slow heart rate)

2) Hypertension (high blood pressure)

3) Narrow pulse pressure (the difference between systolic and diastolic pressures is less than 20 mmHg)

What does Pulsus alternans indicate?

Pulsus alternans is an alteration in the regularity of the heartbeat.

Normally, the heart beats with an even rhythm, and each beat causes the heart to contract and relax. This contraction is called systole, and the relaxation is called diastole. A normal pulse rate is about 60-80 beats per minute (bpm). In pulsus alternans, there is a change in how long it takes for systole and diastole to occur.

The heart contracts with a first beat that lasts longer than usual, then contracts less strongly with subsequent beats. This pattern creates an irregular pulse pattern called pulsus alternans.

Pulsus alternans is a sign of cardiac pump failure.

Pulsus alternans is a sign of cardiac pump failure. It is characterized by alternating strong and weak systolic blood pressure waves that are of equal amplitude. Pulsus alternans may be seen in the setting of severe left ventricular (LV) systolic dysfunction, valvular heart disease, or cardiomyopathy.

The underlying cause of pulsus alternans can be difficult to determine. Therefore, it is important for clinicians to consider all possible causes when evaluating this finding.

Pulsus alternans is a sign of impaired cardiac contractility. It is associated with reduced stroke volume and cardiac output, and may be an early sign of heart failure.

Pulsus alternans is defined as a regular variation in the amplitude of arterial pressure during systole, with successive beats of the same intensity but alternating in their amplitude. The greater the difference between two consecutive beats, the more severe the pulsus alternans.

In most cases, it is caused by a dysfunction of the myocardium that causes poor ventricular performance. Pulsus alternans can be caused by any condition that reduces stroke volume or cardiac output including:

Heart failure

Myocardial ischemia


Valvular heart disease (particularly mitral regurgitation)

What causes electrical alternans ECG?

What causes electrical alternans ECG
What causes electrical alternans ECG

Electrical alternans ECG is a sign of heart muscle dysfunction. It occurs when the electrical activity of the heart becomes abnormal.

Electrical alternans ECG is most often seen in patients with heart failure or cardiomyopathy (disease of the heart muscle). This condition can be caused by ischaemia (restricted blood flow) or arrhythmia (abnormal heartbeat).

Electrical alternans ECG may also occur in patients with heart failure that has been treated successfully with medications known as beta-blockers or calcium channel blockers.

Electrical alternans ECG is an abnormal variation in the electrical axis of the heart that can be seen on an electrocardiogram (ECG). Electrical alternans occurs when the electrical axis of the heart changes within a single heartbeat. This means that the electrical currents flowing through the heart are not moving in a straight line, but rather are moving in an alternating pattern.

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The term “electrical alternans” is often used interchangeably with “electrical alternation”, but they are not exactly the same thing. Electrical alternans refers to a change in electrical axis, while electrical alternation refers to a change in voltage and current.

Electrical alternans is most commonly seen during ventricular fibrillation (VF). It’s also sometimes seen during premature ventricular contractions (PVCs) or rapid atrial fibrillation (AF).

Electrical alternans ECG is a type of abnormal heart rhythm that can occur in patients with heart failure. Electrical alternans occurs when the electrical impulse produced by the heart’s sinoatrial node (SA node) travels in an irregular pattern, causing the heart to beat at different rates. The rate at which the SA node fires may increase or decrease with each beat, resulting in an irregular heartbeat that can be detected by an electrocardiogram (ECG).

Electrical alternans ECG is usually caused by changes in fluid volume within the chambers of the heart. This fluid shift may be due to abnormal blood volume or abnormal electrolyte concentrations within your blood. Other causes include:

Heart failure, which results from weak pumping action of the heart muscle

Low levels of potassium and magnesium in your blood (hypokalemia and hypomagnesemia)

Heart attack (myocardial infarction), which occurs when there is damage to heart muscle due to lack of oxygen

Why is Pulsus alternans in LVF?

It is an early sign of failing LV.

Pulsus alternans is an oscillating pulse. It occurs in patients with severe LVF where the left ventricle fails to pump out blood at a regular rate and rhythm. The result is that there is alternation between periods when the heart beats weakly, producing a strong pulse; and periods when it beats vigorously, producing a weak pulse.

In healthy individuals, there is a continuous back and forth movement of the blood from the ventricle into the artery. This results in a regular beat of the heart that can be felt by placing one’s hand on the chest wall. In patients with LVF, this beat becomes irregular due to impaired pumping ability of the heart muscle

Pulsus alternans is a sign of left ventricular failure. It is a regular but irregular pulse with an underlying rhythm of 120 beats per minute.

Pulsus alternans is caused by a lack of adequate blood supply to the heart muscle resulting from high blood pressure or heart valve incompetence. The underlying rhythm may be normal or slow, depending on whether the patient has atrial fibrillation or atrial flutter.

The most common cause of pulsus alternans is mitral stenosis that can occur in rheumatic fever and other forms of valvular heart disease.

How do you check Pulsus alternans?

The Pulsus Alternans is a sign of HF. It is defined as a variation in the pulse pressure during the cardiac cycle (i.e., between systole and diastole). The normal pulse pressure is 5-10 mmHg.

The Pulsus Alternans can be measured by Doppler Ultrasound. The recording of the Doppler signal during diastole is done with a transducer placed on the anterior chest wall above the heart or on the abdomen above the liver. The pulsus alternans phenomenon can also be assessed by palpating the radial artery or carotid artery with a stethoscope and listening for changes in pulse volume during systole and diastole.

Pulsus alternans is a sign that can be observed during the physical examination. It is defined as a variation of pulse amplitude with each heart beat.

Pulsus alternans can be considered as an alteration of the pulse quality. It is characterized by an increase in the amplitude of the arterial pressure wave during systole and its decrease during diastole. The pulse pressure is usually increased and the pulse rate is reduced.

Pulsus alternans is usually seen in patients with severe heart failure, especially when they have pulmonary edema (fluid in the lungs). Fluid overload increases intrathoracic pressure, which reduces venous return and increases left ventricular afterload. This results in a reduction of stroke volume, which is compensated by an increase in heart rate (sinus tachycardia).