Skip to main content
SpringerLink
Log in

EKG-Befunde bei primär neurologischen Erkrankungen, Systemerkrankungen und primären Kardiomyopathien

  • Schwerpunkt
  • Published:
Herzschrittmachertherapie + Elektrophysiologie Aims and scope Submit manuscript

Zusammenfassung

Das EKG ist einfach, kostengünstig, flächendeckend verfügbar und nicht nur bei primär kardialen Erkrankungen in der Diagnostik eine sinnvolle Ergänzung. So können z. B. zerebrale Ischämien und Hirnblutungen mit unspezifischen EKG-Veränderungen, aber auch myokardischämietypischen Veränderungen assoziiert sein. Ebenso können sich Systemerkrankungen im EKG manifestieren. Oft sind Störungen im Reizleitungssystem mit AV-Blockierungen vorhanden. Bei Sarkoidose-Patienten, aber insbesondere auch in Zecken-Endemie-Gebieten (Borreliose) sollte immer an eine kardiale Mitbeteiligung gedacht werden. Das EKG zeigt bei primären Kardiomyopathien gelegentlich wegweisende Befunde, wie „Pseudo-Infarkt-Q-Zacken“ bei einer hypertrophen Kardiomyopathie oder Epsilon-Potenziale bei einer arrhythmogenen rechtsventrikulären Kardiomyopathie. Die Tako-Tsubo-Kardiomyopathie zeigt typischerweise transiente ST-Streckenhebungen und stellt eine wichtige Differenzialdiagose zum akuten Myokardinfarkt dar.

Abstract

ECG diagnostic is not only an easy to use, cost efficient, extensively available method for cardiological patients, but also a potential tool in diagnostic for other morbidities. As a well-known example, cerebral hemorrhage and ischemia can show an ECG, that resembles an acute coronary syndrome. Furthermore systemic diseases may show characteristic ECG; often as a malfunction of the conductive system (e.g., AV block). Exclusion of cardiac involvement when dealing with sarcoidosis is important, and the ECG may be a first hint. Besides, in Ixodid endemic areas a cardiological manifestation of Borreliosis should be considered. ECG may also show almost specific findings in primary cardiomyopathies, such as the “pseudo-infarction Q – wave” in hypertrophic cardiomyopathy or “epsilon potentials” in arrhythmogenic right ventricular cardiomyopathy. The takotsubo cardiomyopathy commonly reveals transient ST-segment elevation and therefore depicts an important differential diagnosis of acute coronary syndromes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5

Literatur

  1. Burch GE, Meyers R, Abildskov JA (1954) A new electrocardiographic pattern observed in cerebrovascular accidents. Circulation 9:719–723

    Article  PubMed  CAS  Google Scholar 

  2. Sommargren CE, Zaroff JG, Banki N, Drew BJ (2002) Electrocardiographic repolarization abnormalities in subarachnoid hemorrhage. J Electrocardiol 35(Suppl):257–262

    Article  PubMed  Google Scholar 

  3. Liu Q, Ding YH, Zhang JH, Lei H (2011) Ecg change of acute subarachnoid hemorrhagic patients. Acta Neurochir Suppl 111:357–359

    Article  PubMed  Google Scholar 

  4. Tung P, Kopelnik A, Banki N, Ong K, Ko N, Lawton MT, Gress D, Drew B, Foster E, Parmley W, Zaroff J (2004) Predictors of neurocardiogenic injury after subarachnoid hemorrhage. Stroke 35:548–551

    Article  PubMed  Google Scholar 

  5. Naidech AM, Kreiter KT, Janjua N, Ostapkovich ND, Parra A, Commichau C, Fitzsimmons BF, Connolly ES, Mayer SA (2005) Cardiac troponin elevation, cardiovascular morbidity, and outcome after subarachnoid hemorrhage. Circulation 112:2851–2856

    Article  PubMed  CAS  Google Scholar 

  6. Banki N, Kopelnik A, Tung P, Lawton MT, Gress D, Drew B, Dae M, Foster E, Parmley W, Zaroff J (2006) Prospective analysis of prevalence, distribution, and rate of recovery of left ventricular systolic dysfunction in patients with subarachnoid hemorrhage. J Neurosurg 105:15–20

    Article  PubMed  Google Scholar 

  7. Goldstein DS (1979) The electrocardiogram in stroke: relationship to pathophysiological type and comparison with prior tracings. Stroke 10:253–259

    Article  PubMed  CAS  Google Scholar 

  8. Katsanos AH, Korantzopoulos P, Tsivgoulis G, Kyritsis AP, Kosmidou M, Giannopoulos S (2012) Electrocardiographic abnormalities and cardiac arrhythmias in structural brain lesions. Int J Cardiol. Epub ahead of print

  9. Ibrahim GM, Macdonald RL (2012) Electrocardiographic changes predict angiographic vasospasm after aneurysmal subarachnoid hemorrhage. Stroke 43:2102–2107

    Article  PubMed  Google Scholar 

  10. Barber M, Morton JJ, Macfarlane PW, Barlow N, Roditi G, Stott DJ (2007) Elevated troponin levels are associated with sympathoadrenal activation in acute ischaemic stroke. Cerebrovasc Dis 23:260–266

    Article  PubMed  CAS  Google Scholar 

  11. Hagendorff A, Pavlidis C, Jung W, Luderitz B (1995) Cerebrogenic ecg changes after severe subarachnoid hemorrhage from an internal carotid artery aneurysm–differential diagnosis of acute myocardial infarct. Z Kardiol 84:808–813

    PubMed  CAS  Google Scholar 

  12. Jallon P (1997) Epilepsy and the heart. Rev Neurol 153:173–184

    PubMed  CAS  Google Scholar 

  13. Bardai A, Lamberts RJ, Blom MT, Spanjaart AM, Berdowski J, van der Staal SR, Brouwer HJ, Koster RW, Sander JW, Thijs RD, Tan HL (2012) Epilepsy is a risk factor for sudden cardiac arrest in the general population. PloS One 7:e42749

    Article  PubMed  CAS  Google Scholar 

  14. Jain, S, Ton, TG, Perera, S, Zheng, Y, Stein, PK, Thacker, E, Strotmeyer, ES, Newman, AB, Longstreth, WT, Jr., (2012) Cardiovascular physiology in premotor parkinson’s disease: a neuroepidemiologic study. Mov Disord 27:988–995

    Article  PubMed  Google Scholar 

  15. Seferovic PM, Ristic AD, Maksimovic R, Simeunovic DS, Ristic GG, Radovanovic G, Seferovic D, Maisch B, Matucci-Cerinic M (2006) Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases. Rheumatology (Oxford) 45(Suppl 4):iv39–42

    Article  Google Scholar 

  16. Haddad FA, Nadelman RB (2003) Lyme disease and the heart. Front Biosci 8:s769–782

    Article  PubMed  Google Scholar 

  17. Murtagh B, Hammill SC, Gertz MA, Kyle RA, Tajik AJ, Grogan M (2005) Electrocardiographic findings in primary systemic amyloidosis and biopsy-proven cardiac involvement. Am J Cardiol 95:535–537

    Article  PubMed  Google Scholar 

  18. Silverman KJ, Hutchins GM, Bulkley BH (1978) Cardiac sarcoid: a clinicopathologic study of 84 unselected patients with systemic sarcoidosis. Circulation 58:1204–1211

    Article  PubMed  CAS  Google Scholar 

  19. Dechering DG, Kochhauser S, Wasmer K, Zellerhoff S, Pott C, Kobe J, Spieker T, Piers SR, Bittner A, Monnig G, Breithardt G, Wichter T, Zeppenfeld K, Eckardt L (2013) Electrophysiological characteristics of ventricular tachyarrhythmias in cardiac sarcoidosis versus arrhythmogenic right ventricular cardiomyopathy. Heart Rhythm 10:158–164

    Article  PubMed  Google Scholar 

  20. Maron BJ (2001) The electrocardiogram as a diagnostic tool for hypertrophic cardiomyopathy: revisited. Ann Noninvasive Electrocardiol 6:277–279

    Article  PubMed  CAS  Google Scholar 

  21. Yamaguchi H, Ishimura T, Nishiyama S, Nagasaki F, Nakanishi S, Takatsu F, Nishijo T, Umeda T, Machii K (1979) Hypertrophic nonobstructive cardiomyopathy with giant negative t waves (apical hypertrophy): ventriculographic and echocardiographic features in 30 patients. Am J Cardiol 44:401–412

    Article  PubMed  CAS  Google Scholar 

  22. Gianni M, Dentali F, Grandi AM, Sumner G, Hiralal R, Lonn E (2006) Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. Eur Heart J 27:1523–1529

    Article  PubMed  Google Scholar 

  23. Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS (2004) Systematic review: transient left ventricular apical ballooning: a syndrome that mimics st-segment elevation myocardial infarction. Ann Intern Med 141:858–865

    Article  PubMed  Google Scholar 

  24. Wang JG, Li YJ, Liu H, Li NN, Zhao J, Xing XM (2012) Clinicopathologic analysis of cardiac myxomas: seven years’ experience with 61 patients. J Thorac Dis 4:272–283

    PubMed  Google Scholar 

  25. Montiel V, Maziers N, Dereme T (2007) Primary cardiac lymphoma and complete atrio-ventricular block: case report and review of the literature. Acta Cardiol 62:55–58

    Article  PubMed  Google Scholar 

  26. Agaimy A, Rosch J, Weyand M, Strecker T (2012) Primary and metastatic cardiac sarcomas: a 12-year experience at a german heart center. Int J Clin Exp Pathol 5:928–938

    PubMed  Google Scholar 

Download references

Interessenkonflikt.

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Abteilung für Rhythmologie, Department für Kardiologie und Angiologie, Universitätsklinikum Münster, Albert Schweitzer Campus 1, Gebäude A1, 48149, Münster, Deutschland

    E. Kaya, C. Fischer & L. Eckardt

Authors
  1. E. Kaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Eckardt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Kaya.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kaya, E., Fischer, C. & Eckardt, L. EKG-Befunde bei primär neurologischen Erkrankungen, Systemerkrankungen und primären Kardiomyopathien. Herzschr Elektrophys 24, 109–114 (2013). https://doi.org/10.1007/s00399-013-0262-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00399-013-0262-x

Schlüsselwörter

Keywords

Search

Navigation