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13 Possible Causes for Ejection Fraction Decreased, Poor R Wave Progression, Pulmonary Systolic Murmur

  • 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] RESULTS The concentrations of galectin-3 and NT-proBNP were substantially higher following decreased ejection fraction (both P 0.000), except for sST2 (P 0.068 vs. control[ncbi.nlm.nih.gov]

  • 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] Third and fourth heart sound, systolic murmur if mitral regurgitation or ventricular septal defect develops, pericardial rub.[patient.info] Bedside echocardiography disclosed akinesis of the anterior and lateral walls, apex, and anterior septum with severely decreased left ventricular ejection fraction of 30%.[ncbi.nlm.nih.gov]

  • 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] Third and fourth heart sound, systolic murmur if mitral regurgitation or ventricular septal defect develops, pericardial rub.[patient.info] After start of the GFD, abnormal left ventricular dimensions, and diminished cardiac function, including decreased ejection fraction, can improve markedly and may even be[dx.doi.org]

  • Anterior Myocardial Infarction

    The remarkable feature is the poor R wave progression in the V1 and V2 leads and the ST elevation and T wave changes in leads V1 to V4 and I and aVL.[wikidoc.org] Third and fourth heart sound, systolic murmur if mitral regurgitation or ventricular septal defect develops, pericardial rub.[patient.info] Conventional ultrasound: Acute phase The global LV systolic function directly after the myocardial infarction was moderately decreased with a left ventricular ejection fraction[specklepedia.com]

  • Acute Cor Pulmonale

    […] and pulmonic insufficiency murmurs, and later, distended jugular veins, hepatomegaly, and lower-extremity edema.[merckmanuals.com] Prostaglandins decrease pulmonary artery pressure and increase right ventricular ejection fraction and cardiac output.2.[slideshare.net] […] right ventricular ejection fraction; dilatation of the inferior vena cava and hepatic veins; and pericardial effusion ( Fig 7 ) ( 31 – 34 ).[pubs.rsna.org]

  • Restrictive Cardiomyopathy

    Figure 3 shows atrial fibrillation, poor R wave progression, and diffuse ST-segment abnormalities in an ECG from a patient with ischemic cardiomyopathy.[clevelandclinicmeded.com] Presentation Usually presents with heart failure but normal systolic function: dyspnoea, fatigue, loud third heart sound, pulmonary oedema, murmurs due to valve incompetence[patient.info] And when the heart isn't able to fill properly, even if it contracts, and has a normal ejection fraction, you're still going to have a decreased volume of blood exiting the[khanacademy.org]

  • Acute Atrial Infarction

    In contrast, poor R wave progression is commonly observed with LVH and with acute or chronic right ventricular overload.[angelfire.com] He had an irregular heart rate and an apical systolic murmur /6 . Inferior limb edema, as well as varicose veins, were not noted.[scielo.br] On transthoracic echocardiography, 11 patients had no detectable thrombus, 5 had wall-motion abnormality or a decreased left ventricular ejection fraction, 2 had severe mitral[journals.lww.com]

  • 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] There may be systolic murmur of mitral regurgitation and tricuspid regurgitation.[brown.edu] It also showed the dilatation and functional impairment of the left ventricle (end diastolic diameter: 60mm, end diastolic volume: 243ml and ejection fraction decreased by[escardio.org]

  • Alcoholic Cardiomyopathy

    Figure 3 shows atrial fibrillation, poor R wave progression, and diffuse ST-segment abnormalities in an ECG from a patient with ischemic cardiomyopathy.[clevelandclinicmeded.com] Third and fourth heart sounds can be heard, and they signify systolic and diastolic dysfunction.[emedicine.com] He had a history of progressively worsening dyspnoea and encephalopathy, from decreasing ejection fraction.[ncbi.nlm.nih.gov]

  • Right Ventricular Hypertrophy

    Figure 3 shows atrial fibrillation, poor R wave progression, and diffuse ST-segment abnormalities in an ECG from a patient with ischemic cardiomyopathy.[clevelandclinicmeded.com] On auscultation, an accentuated second pulmonary sound (S2), a third heart sound termed a ‘right ventricular gallop’, as well as a systolic murmur over the tricuspid area[en.wikipedia.org] LV performance (myocardial performance index) decreased during the progression of RVH, although the LV ejection fraction was maintained.[ncbi.nlm.nih.gov]

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