Jamalud Din, Fazli Rahim, Zahidullah Khan, Hamza Khan, Muhammad Taimur Khan.
Electrocardiographic findings in patients with heart failure.
J Med Sci Jan ;19(1):18-20.

Objective: To know the clinical and Electrocardiographic findings in patients with congestive cardiac failure (CCF) or simply heart failure (HF). Material and Methods: This hospital based descriptive study was conducted in Department of Medicine, Khyber Teaching Hospital, Peshawar from December 2007 to June 2008. A total of 100 admitted patients with clinical and echocardiographic evidence of congestive cardiac failure were randomly selected. A detailed history was taken and clinical examination was done with special consideration of the cardiovascular system. The clinical diagnosis was established by the simultaneous presence of at least two major, or one major and two minor criteria according to Framingham Heart Study criteria for the diagnosis of heart failure. The patients were noninvasively investigated, including 12-leads ECG and echocardiogram. Results: The study included 100 patients with clinical and echocardiographic evidence of heart failure. There were 52 male and 48 female patients. The mean age was 51±5 years. None of the included patients with CCF had normal ECG. ECG abnormalities consistent with ischemic pattern were observed in 46%, left ventricular hypertrophy (LVH) in 28% and cor pulmonale in 12%. In 14%, the ECG pattern was non-specifically abnormal, like low voltages and specific repolarization changes. Conclusion: ECG has always some abnormality in patients with heart failure. The normal ECG virtually excludes the diagnosis of heart failure.

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