PROGNOSTIC SIGNIFICANCE OF LOW QRS VOLTAGE ON THE ADMISSION ELECTROCARDIOGRAM IN ACUTE CORONARY SYNDROMES


Swara A. Mawlood a, Farman J. Ahmed a, Amar Talib Al-Hamdi b, and Mohammad M. Arif



a  Department of Cardiology, Sulaimani Teaching Hospital, Interventional Cardiology Center, Kurdistan Region, Iraq.
b Consultant Cardiologist and Electrophysiologist, Sulaimani, Kurdistan Region, Iraq. 



Submitted: 25/1/2022; Accepted: 15/4/2022; Published: 21/6/2022


ABSTRACT 


Background 

Myocardial infarction is one of the most common causes of mortality in middle and older age groups, especially in ventricular arrhythmia. Patients will be identified as having low QRS Voltage when peak-to-peak QRS complex voltage is less than 0.5 mV in all limb leads and less than 1.0 mV in all precordial leads.


Objectives 

To find the correlation between low QRS voltage in the hospital and one-month outcome of patients presenting with the acute coronary syndrome.


Patients and Methods

A prospective longitudinal study was performed on 400 patients admitted with the confirmed acute coronary syndrome and underwent percutaneous coronary intervention.


Results

The mean age was 61. ± 11.8years ranged from 22 to 90 years. Male was 67.8%, and 32.3% were female. The percentage of hypertension, diabetes mellitus, and previous myocardial infarction were 66.3%, 32.8% and 12.3%, respectively. Low QRS voltage was found in 17 patients (4.3%). Most of our patients (43.5%) had an anterior myocardial infarction, of which the culprit lesion was the Left Anterior Descending artery. An ejection fraction of more than 50% on echocardiography was found in 68.3% of them; additionally, 84.7% had a Killip Class of one. Therefore, in-hospital death was 4.8%. Furthermore, the total death from admission to a month post-myocardial infarction was 9%. Fourteen patients had re-admission within that period for cardiac events. 


Conclusion

Low QRS in presenting electrocardiogram patients with the acute coronary syndrome will be significantly associated with hospital and one-month morbidity and mortality.



KEYWORDS

Acute Myocardial Infarction, Low QRS complex, Electrocardiography.