The electrocardiogram in obesity

Eisenstein, Isaac; Edelstein, Josef; Sarma, Radha J.; Sanmarco, Miguel E.; Selvester, Ronald H.

doi:10.1016/s0022-0736(82)80003-4

Cited by 66 publications

(41 citation statements)

References 4 publications

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“…In addition to low QRS voltage and leftward trend in the axis, other frequent alterations seen are nonspecific flattening of the T wave in the inferolateral leads (attributed to the horizontal displacement of the heart) and voltage criteria for left atrial abnormality. [101][102][103] More frequent STsegment depression is seen in overweight patients with CHD. 104 Weight loss induces a rightward shift of the QRS axis, 105,106 but conduction intervals (duration of the P wave, QRS complex, and the PQ interval) are not affected by weight loss.…”

Section: Electrocardiogrammentioning

confidence: 99%

Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss

Poirier¹,

Giles²,

Bray³

et al. 2006

Circulation

2,729

1,463

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Abstract-Obesity is becoming a global epidemic in both children and adults. It is associated with numerous comorbidities such as cardiovascular diseases (CVD), type 2 diabetes, hypertension, certain cancers, and sleep apnea/sleep-disordered breathing. In fact, obesity is an independent risk factor for CVD, and CVD risks have also been documented in obese children. Obesity is associated with an increased risk of morbidity and mortality as well as reduced life expectancy. Health service use and medical costs associated with obesity and related diseases have risen dramatically and are expected to continue to rise. Besides an altered metabolic profile, a variety of adaptations/alterations in cardiac structure and function occur in the individual as adipose tissue accumulates in excess amounts, even in the absence of comorbidities. Hence, obesity may affect the heart through its influence on known risk factors such as dyslipidemia, hypertension, glucose intolerance, inflammatory markers, obstructive sleep apnea/hypoventilation, and the prothrombotic state, in addition to as-yet-unrecognized mechanisms. On the whole, overweight and obesity predispose to or are associated with numerous cardiac complications such as coronary heart disease, heart failure, and sudden death because of their impact on the cardiovascular system. The pathophysiology of these entities that are linked to obesity will be discussed. However, the cardiovascular clinical evaluation of obese patients may be limited because of the morphology of the individual. In this statement, we review the available evidence of the impact of obesity on CVD with emphasis on the evaluation of cardiac structure and function in obese patients and the effect of weight loss on the cardiovascular system. (Circulation. 2006;113:898-918.)

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Section: Electrocardiogrammentioning

confidence: 99%

Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss

Poirier¹,

Giles²,

Bray³

et al. 2006

Circulation

2,729

1,463

View full text Add to dashboard Cite

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“…Some common changes include left axis deviation likely due to displacement of the heart from raised diaphragm due to abdominal visceral fat and small voltages (Eisenstein, Edelstein et al 1982;Frank, Colliver et al 1986;Alpert, Terry et al 2000;Poirier, Giles et al 2006) from the increased distance between the heart and the chest wall (Poirier, Giles et al 2006). Cardiac work load is also increased (Lavie, Milani et al 2009) and this could lead to left ventricular hypertrophy (Lauer, Anderson et al 1991;Poirier, Giles et al 2006;Avelar, Cloward et al 2007;Lavie, Milani et al 2009;Movahed, Martinez et al 2009).…”

Section: Electrocardiogram (Ecg)mentioning

confidence: 99%

“…Pulmonary diseases such as obstructive sleep apnoea could cause cor pulmonale changes. Other possible ECG changes are increased in heart rate (Frank, Colliver et al 1986;Poirier, Giles et al 2006), prolonged PR interval (Frank, Colliver et al 1986;Poirier, Giles et al 2006;Seyfeli, Duru et al 2006), prolonged QRS interval (Frank, Colliver et al 1986;Poirier, Giles et al 2006), prolonged QTc interval (Frank, Colliver et al 1986;Alpert, Terry et al 2000;Pontiroli, Pizzocri et al 2004;Poirier, Giles et al 2006;Arslan, Yiginer et al 2010), ST-T wave abnormalities (Frank, Colliver et al 1986;Poirier, Giles et al 2006) and flattening of the T wave especially in the inferolateral leads (Eisenstein, Edelstein et al 1982;Alpert, Terry et al 2000; Lopez-Jimenez and CortesBergoderi 2011).…”

Section: Electrocardiogram (Ecg)mentioning

confidence: 99%

Medical Assessment and Preparation of Patients Undergoing Bariatric Surgery

Leong¹,

Taheri²

2012

Advanced Bariatric and Metabolic Surgery

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“…26,41 Most experts now feel that the role of the EKG in diagnosing PE is quite limited. 42 In particular, the clinical usefulness of specific EKG patterns (i.e.…”

Section: Electrocardiography (Ekg) and Echocardiographymentioning

confidence: 99%

Difficulties in diagnosing pulmonary embolism in the obese patient: A literature review

Hawley

2011

Vasc Med

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Several of the signs and symptoms of pulmonary embolism, such as dyspnea, tachypnea, and tachycardia, are common in the obese population, so these patients are frequently suspected of having a pulmonary embolism. Establishing an accurate diagnosis in this situation is often difficult. We performed a review of the literature examining the difficulty of diagnosing pulmonary embolism in obese patients. Several factors compromise the ability of clinicians to accurately diagnose pulmonary embolism in obese patients. When patients weigh over 350 lbs (159 kg), thoracic imaging often cannot be performed because of the weight limitations of the scanning equipment. If equipment is available that can scan these patients, image quality is often poor. The literature that is available to guide the clinician in this difficult clinical scenario is sparse. Access to radiology equipment that can image morbidly obese patients is improving, but questions about image quality remain. Further research on both imaging and outcomes is needed.

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The electrocardiogram in obesity

Cited by 66 publications

References 4 publications

Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss

Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss

Medical Assessment and Preparation of Patients Undergoing Bariatric Surgery

Difficulties in diagnosing pulmonary embolism in the obese patient: A literature review

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