Tuberculosis electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mashal Awais, M.D.[2]; Alejandro Lemor, M.D. [3]

Overview

Patients with pulmonary tuberculosis often have a normal EKG, but pericardial effusion may occur leading to EKG changes. Extra-pulmonary tuberculosis, such as tuberculous pericarditis, can show EKG changes.

Patients may get a pericardial effusion secondary to tuberculosis and this may present as as low voltage and tachycardia on an EKG.
In patients who develop tuberculous pericarditis, the ECG may show non-specific ST segment and T-wave changes.^[1]^[2]
Characteristic EKG finding of acute pericarditis, PR-segment depression, and diffuse ST-segment elevation are found in only 9-11% of cases^[3]^[2].
The detection of a low QRS voltage and electrical alternans on EKG indicates a pericardial effusion and / or tamponade.

↑ SCHRIRE V (1959). “Experience with pericarditis at Groote Schuur Hospital, Cape Town: an analysis of one hundred and sixty cases studied over a six-year period”. S Afr Med J. 33: 810–7. PMID 14443596.
↑ ^2.0 ^2.1 Smedema JP, Katjitae I, Reuter H, Burgess L, Louw V, Pretorius M; et al. (2001). “Twelve-lead electrocardiography in tuberculous pericarditis”. Cardiovasc J S Afr. 12 (1): 31–4. PMID 11447490.
↑ Rooney JJ, Crocco JA, Lyons HA (1970). “Tuberculous pericarditis”. Ann Intern Med. 72 (1): 73–81. PMID 5410398.