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15 Possible Causes for Agitation, Poor R Wave Progression, Pulmonary Systolic Murmur

  • Pulmonary Embolism

    Hypoxia, which may cause anxiety, restlessness, agitation and impaired consciousness. Pyrexia. Elevated jugular venous pressure.[patient.info] Signs of pulmonary hypertension, such as palpable impulse over the second left intercostal space, loud P 2, right ventricular S 3 gallop, and a systolic murmur louder on inspiration[emedicine.medscape.com] A CNS toxicity phase (agitation evolving to frank seizures or CNS depression) may precede cardiovascular collapse.[doi.org]

  • Acute Myocardial Infarction

    Biphasic/inverted T waves in V1-5. Poor R wave progression (R wave height 3mm in V3). Abnormal Q waves and T-wave inversion in I and aVL.[lifeinthefastlane.com] A catheter was placed in the right atrium in front of the fossa ovalis, and agitated saline solution was injected while the anesthesiologist induced a Valsalva maneuver.[pediatrics.aappublications.org] Diagnosis is made by detection of a new systolic murmur, and by the documentation of giant "V-waves" on the pulmonary capillary wedge tracing.[brown.edu]

  • Cor Pulmonale

    R wave progression RAE with and RVH multifocal atrial tachycardia return to top Differential Diagnosis return to top Treatments Consequences and Course return to top The[sharinginhealth.ca] […] vasodilation and decreased venous return/preload leading to RV cardiac output to worsening RV ischemia to worsening RV failure Intubation with inadequate sedation leads to pain and agitation[emcrit.org] Split second heart sound with loud pulmonary component. Systolic ejection murmur with a sharp ejection click over the pulmonary artery (advanced sign).[patient.info]

  • Myocardial Infarction

    Biphasic/inverted T waves in V1-5. Poor R wave progression (R wave height 3mm in V3). Abnormal Q waves and T-wave inversion in I and aVL.[lifeinthefastlane.com] Hyperthermic complications Excessive cocaine use can result in hallucinations, agitation, and hyperthermia, and management is urgent.[doi.org] Signs Signs of impaired myocardial function 3 rd / 4 th heart sounds Pan systolic murmur Pericardial rub Pulmonary oedema – crepitations in the lungs Hypotension Quiet first[almostadoctor.co.uk]

  • Heart Failure

    Electrocardiography demonstrated poor R-wave progression in leads V1-V3 with right axis deviation and low voltage criteria.[ncbi.nlm.nih.gov] The characteristic apical systolic murmur may be absent in patients with severe MR, due to the abrupt and severe elevation of left atrial pressure.[doi.org] We report a case of a 50-year-old man who was admitted with evolution of progressive dyspnea.[ncbi.nlm.nih.gov]

  • Acute Cor Pulmonale

    PFO was detected during a contrast study using agitated saline in the transesophageal bicaval view.[ncbi.nlm.nih.gov] Split second heart sound with loud pulmonary component. Systolic ejection murmur with a sharp ejection click over the pulmonary artery (advanced sign).[patient.info] PFO was detected during a contrast study using agitated saline in the TEE bicaval view, without provoking maneuvers such as end-inspiratory breath holding or sudden release[ccforum.biomedcentral.com]

  • Paradoxical Embolism

    The electrocardiogram showed sinus rhythm (heart rate 61 bpm), first-degree atrioventricular block, right atrial abnormality, poor R-wave progression in the anterior wall[elsevier.pt] Amongst them, 253 subjects underwent agitated saline TCD monitoring and 128 (51%) had right-to-left shunts (RLS).[ncbi.nlm.nih.gov] Cardiac auscultation revealed a systolic murmur at the left lower sternal border and a splitting of the second heart sound in the pulmonary area.[romanianjournalcardiology.ro]

  • Scorpion Envenomation

    ECG showed bradycardia in hyperacute T wave and poor R wave progression each in one patient "T" wave inversion and tall "T" waves were seen in three patients, respectively[smjonline.org] All patients had resolution of abnormal motor activity and agitation during their midazolam infusion.[ncbi.nlm.nih.gov] murmur).[bmj.com]

  • Heart Block

    […] in leads I and/or aVL R-peak time in lead aVL 0.04s, often with slurred R wave downstroke QRS duration usually 0.12s unless coexisting RBBB Usually see poor R progression[ecg.utah.edu] Sixty minutes later, the patient became agitated and confused, which was followed by loss of consciousness and oculogyric movements.[anesthesiology.pubs.asahq.org] Cardiovasular examination revealed ejection systolic murmur in the pulmonary area with single S2.[ncbi.nlm.nih.gov]

  • Left Ventricular Dilatation

    Poor R-wave progression with QS complexes in V1-4 (“pseudo-infarction” pattern). Frequent ventricular ectopics and ventricular bigeminy (seen with severe DCM).[lifeinthefastlane.com] All participants underwent contrast-enhanced echocardiography by infusion of agitated saline solution.[journals.plos.org] DD :from other causes of systolic murmur; Aortic stenosis. 24 Investigations: 1.Plain chest X-ray: - LV enlargement. - signs of pulmonary congestion. 2.ECG: - P mitral. -[slideplayer.com]

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