Published: 2021-08-21

Electrocardiography can be a clue to underlying cardiomyopathy

Atiullah Imran Malik, Sangram Mangudkar, Yadav Ponvijaya, Vijayashree Gokhale


Background: Electrocardiography (ECG) is an accessible, low cost diagnostic and prognostic tool. Recent studies have shown increased risk of deaths associated with cardiomyopathy and to study the patients with symptoms of cardiomyopathy on basis of ECG.

Methods: A total of 50 patients were explained the procedure and the purpose of the study, informed consent was taken from the patient or the relative in a language they can understand. Required physical examination and necessary investigations were carried out. In our study, maximum subjects had normal voltage (80%) low voltage ECG findings were in 20%, normal QRS complex in 78%, wide QRS complex in 20% LBBB/RBBB in 24%. Evidence of ischemia like T wave changes in 34%, ST wave changes in 24% and tachycardia (26%). Thus ECG can give a clue for diagnosing cardiomyopathy and guide us for further managements but it is not a diagnostic marker for it since most of the patients had normal ECG findings.

Results: In our study, electrocardiogram findings among patients are: Maximum subjects had normal voltage (80%). Low voltage ECG findings were in 20%. Normal QRS complex in 78%, wide QRS complex in 20% LBBB/RBBB in 24%. Evidence of ischemia in 58% and tachycardia (26%).

Conclusions: ECG is an accessible, low cost diagnostic and prognostic tool. Most common findings in cardiomyopathy is biventricular hypertrophy and left bundle branch block with wide QRS complex, low voltage ECG and ST changes as also seen in present study. Thus, ECG can be initial investigation for cardiomyopathy and can give us clue for further investigations and management. 


Cardiomyopathy, ECG, Wide QRS complex, LBBB

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Hare JM. The Dilated, Restrictive, and infiltrative Cardiomyopathies Braunwald‘ Heart Diseases 11th edition. 2019;3912.

Wynne J, Eugene Braunwald‘s E. Cardiomyopathy and Myocarditis. Harrison‘s principles of internal medicine, 20th edition, volume2. 1481-8.

Falk RH, Hershberger RE, Cooper LT, Richard A. Lange Cardiomyopathy, Braunwald‘s Heart Disease 11th Edition, Chapter 77,78,79,80. 4052-151.

Wynne J, Braunwald‘s E. Cardiomyopathy and Myocarditis. Harrison‘s principles of internal medicine, 20th edition volume 2. 1481-8.

Bashore TM, Granger CB, Kevin MD. Cardiomyopathy, Current Medical Diagnosis & Treatment CMDT. 19th Edition, Chapter 10. 425-35.

Newby DE, Grubb NR. Cardiomyopathy Davidson’s Principles & Practice of Medicine. 23nd Edition, Chapter. 538-41.

Arbustini E, Narula N, Tavazzi L. The MOGE(S) classification of cardiomyopathy Sisakian H. Cardiomyopathies: evolution of pathogenesis concepts and potential for new therapies. World J Cardiol. 2014;6(6):478-94.

Basil IB. Diabetic cardiomyopathy: the preclinical phase. BMJ. 1977;1444-46.

Jain A, Tewari S, Kapoor A, Kumar S, Garg N, Goel PK et al. Clinical profile of dilated cardiomyopathy. Indian Heart J. 2004;56:507-17.

Eugene B. Cardiomyopathies an overview. Circulation Research. 2017;1(21):711-21.

Rihal CS, Nishimura RA, Hatle LK. Systolic and diastolic dysfunction in patients with clinical diagnosis of dilated cardiomyopathy relation to symptoms and prognosis. Circulation. 1994;90:2772.

Elkayam U, Tummala PP, Rao K. Maternal and fetal outcomes of subsequent pregnancies in women with peripartum cardiomyopathy. NEJM. 2001;344:1567-71.

Jia G, Hill MA, Sower JR. Diabetic Cardiomyopathy. An Update of Mechanisms Contributing to This Clinical Entity. Circulation Research. 2018;122:624-38.

Maron BJ, Gardin JM. Prevalence of hypertrophic cardiomyopathy in a general population of young adults. Echocardiographic analysis of 4111 subjects in the CARDIA Study. Coronary artery risk development in (young) adults. Circulation. 1995;92:785-9.

Masoomi R, Shah Z, Arany Z, GuptaK. Peripartum Cardiomyopathy: An Epidemiologic Study of Early and Late Presentations. Pregnancy induced Hypertension. 2018;10:273-8.

Codd MB, Surgue DD. Epidemiology of idiopathic dilated and hypertrophic cardiomyopathy: a population-based study in Olmsted country, Minnesota 1975- 1984. Circulation 1989; 80:564-72.

De Maria AN, Blanchard DG. The echocardiogram, Cardiomyopathies. Hursts The Heart 14th edition. 2017;430-3.

Maron BJ, Doerer JJ, Haas TS. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation. 2009;119(8):1085-92.

Rivenes SM. Sudden death and cardiovascular collapse in children with restrictive cardiomyopathy. Circulation. 2000;102(8):876-82.

Hulot JS, Jouven X, Empana JP, Frank R, Fontaine G. Natural history and risk stratification of arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circulation. 2004;110(14):1879-84.

Dalal D, Nasir K. Arrhythmogenic right ventricular dysplasia- A united states experience. Circulation 2005;112:3823-32.

Maisch B. Alcoholic cardiomyopathy. Herz. 2016;41:484-93.

Pilichou K, Thiene G, Bauce B, Rigato I, Lazzarini E, Migliore F et al. Arrhythmogenic cardiomyopathy. Orpha net Journal of Rare Diseases. 2016;11:33.

Elliott P, Andersson B, Arbustini E. Classification of the cardiomyopathies: a position statement from the European Society Of Cardiology working group on myocardial and pericardial diseases. Eur Heart J. 2008;29:270-6.

Chug S. Review of classification of cardiomyopathies. Cardiological society of India. Cardiology updates. 2009;29-34.

Akhmatov YR; Abdullayev TA, Mardanov BU. Clinical Profile and Prognosis of Patients with Right Ventricular Dilated Cardiomyopathy: Results of a Prospective Study. Int J Biomed. 2015;5(4):207-13.

Ammash NM, Seward JB. Clinical profile and outcome of idiopathic restrictive cardiomyopathy. Circulation. 2000;101:2490-6.

Maron BJ, Towbin JA, Thiene G. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation. 2006;113(14):1807-16.

Schamroth L. Congestive cardiomyopathy. A introduction to electrocardiography. 7th edition. 200-1.

Helmy SM, Maauof GF, Shaaban AA. Hypertrophic Cardiomyopathy: Prevalence, Hypertrophy Patterns, and Their Clinical and ECG Findings in a Hospital at Qatar. 2011;12(4):143-9.