Aortic regurgitation electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S; Usama Talib, BSc, MD [3]

Overview

In aortic regurgitation, the electrocardiography findings are nonspecific. Electrocardiographic abnormalities in the patient with aortic regurgitation include left axis deviation and signs of left ventricular hypertrophy.^[1]

Electrocardiogram

Electrocardiographic abnormalities in the patient with aortic regurgitation include:^[1]^[2]^[3]

Nonspecific changes of ST and T wave (due to left ventricular enlargement)
Right coronary artery ischemic changes (suggestive of aortic dissection)
- ST elevation in II, III, aVF (inferior MI)
- ST elevation in V3R and V4R (right ventricle MI)
- ST depression in V1-V3 (posterior MI)
Left ventricular hypertrophy
Left axis deviation
Left atrial enlargement
Left ventricular volume overload pattern (prominent Q waves in leads I, aVL, and V3 to V6 and relatively small R waves in V1)
Left ventricular conduction defects (typically late in the disease process)
Re-polarization abnormalities
ST-segment depression in precordial leads

Shown below is an ECG depicting left ventricular hypertrophy. Copyleft image obtained courtesy of ECGpedia [4]

Shown below is an ECG depicting left axis deviation. Copyleft image obtained courtesy of ECGpedia [5]

References

Overview