The Cor Pulmonale EKG Signs Diagnosis Guide
The Cor Pulmonale EKG Signs Diagnosis Guide Cor pulmonale, also known as right-sided heart failure caused by pulmonary hypertension, represents a significant complication of chronic lung diseases. Detecting it early is crucial for effective management, and the electrocardiogram (EKG or ECG) plays a vital role in its diagnosis. Understanding the characteristic EKG signs associated with cor pulmonale enables clinicians to identify right ventricular strain and hypertrophy, which are hallmarks of this condition.
One of the primary EKG features indicative of cor pulmonale is right axis deviation. Normally, the QRS axis ranges from -30° to +90°, but in cor pulmonale, it shifts rightward beyond +90°, reflecting right ventricular hypertrophy (RVH) and strain. This axis deviation results from the increased workload on the right ventricle due to pulmonary hypertension, causing electrical vectors to shift accordingly.
The presence of right ventricular hypertrophy can be further confirmed by specific QRS changes. In the limb leads, especially lead V1, a tall R wave coupled with a deep S wave in V6 suggests RVH. In lead V1, a prominent R wave exceeding 7mm or an R/S ratio greater than 1 is characteristic of RV hypertrophy. Conversely, in lead V6, a deep S wave may be observed. These changes are reflective of the increased muscle mass and altered electrical activity of the hypertrophied right ventricle.
Right atrial enlargement, another feature associated with cor pulmonale, can also be detected on the EKG. It manifests as peaked P waves exceeding 2.5 mm in height in leads II, III, or aVF, indicating right atrial hypertrophy. This atrial enlargement is often secondary to increased right-sided pressures and volume overload.
Furthermore, right bundle branch block (RBBB) is a common EKG finding in cor pulmonale. RBBB appears as an rsR’ pattern in lead V1, with a widened QRS complex greater than 120 ms. The RBBB reflects conduction delays within the right bundle branch, often due to right ventricular dilation and strain.
Additional subtle signs include T wave inversions in the right precordial leads (V1-V3), which suggest right ventricular strain or ischemia. These T wave changes, combined with the other signs, enhance the likelihood of cor pulmonale, especially when correlated with clinical findings.
Diagnosis of cor pulmonale through EKG should always be integrated with clinical symptoms, imaging, and laboratory findings. While EKG is a valuable screening tool, it is not definitive on its own. Echocardiography remains essential for visualizing right ventricular size and function, and pulmonary hypertension diagnosis may require right heart catheterization.
In summary, key EKG signs for cor pulmonale include right axis deviation, right ventricular hypertrophy patterns, right atrial enlargement, RBBB, and T wave inversions. Recognizing these signs promptly can facilitate early intervention, potentially improving patient outcomes and slowing disease progression.
