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

Schwerpunkt

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.

Schlüsselwörter

EKG-Veränderungen Zentrales Nervensystem Systemerkrankungen Kardiomyopathien 

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.

Keywords

ECG changes Central nervous system Systemic diseases Cardiomyopathy 

Notes

Interessenkonflikt.

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

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Copyright information

© Springer 2013

Authors and Affiliations

  1. 1.Abteilung für Rhythmologie, Department für Kardiologie und AngiologieUniversitätsklinikum MünsterMünsterDeutschland

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