{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:24:24Z","timestamp":1768458264243,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,2,18]],"date-time":"2015-02-18T00:00:00Z","timestamp":1424217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2015,3]]},"abstract":"ABSTRACT<\/jats:title>Background<\/jats:title>Few studies have looked at the utility of the 12\u2010lead electrocardiogram (ECG<\/jats:styled-content>) in diagnosing cardiac tamponade in malignant pericardial effusion (PE<\/jats:styled-content>). The aim of this study was to determine the sensitivity (Se), specificity (Sp), positive predictive value (PPV<\/jats:styled-content>), and negative predictive value (NPV<\/jats:styled-content>) of 12\u2010lead ECG<\/jats:styled-content> in diagnosing cardiac tamponade in PE<\/jats:styled-content>.<\/jats:p><\/jats:sec>Hypothesis<\/jats:title>Abnormalities on a 12 lead ECG can be used to diagnose or exclude cardiac tamponade in patients with malignant PE.<\/jats:p><\/jats:sec>Methods<\/jats:title>Using echocardiography as the gold standard for diagnosis of cardiac tamponade, we determined the Se, Sp, PPV<\/jats:styled-content>, and NPV<\/jats:styled-content> for individual and combinations of the 3 ECG<\/jats:styled-content> abnormalities (low\u2010voltage complexes, electrical alternans, and sinus tachycardia).<\/jats:p><\/jats:sec>Results<\/jats:title>For PEs<\/jats:styled-content> of all sizes, the Se, Sp, PPV<\/jats:styled-content>, and NPV<\/jats:styled-content> for detecting cardiac tamponade were: low\u2010voltage complexes (56%, 74%, 81%, 46%), electrical alternans (23%, 98%, 95%, 39%), and sinus tachycardia (76%, 60%, 79%, 56%), respectively. Presence of all 3 and any of the 3 ECG<\/jats:styled-content> abnormalities had a Se, Sp, PPV<\/jats:styled-content>, and NPV<\/jats:styled-content> of 8%, 100%, 100%, 36% and 89%, 47%, 77%, 69%, respectively, for cardiac tamponade. The odds ratios for cardiac tamponade in PE<\/jats:styled-content> were 3.7 (95% confidence interval [CI<\/jats:styled-content>]: 1.65\u20108.30) for low\u2010voltage complexes, 12.3 (95% CI<\/jats:styled-content>: 1.58\u201095.17) for electrical alternans, and 4.9 (95% CI<\/jats:styled-content>: 2.22\u201010.80) for sinus tachycardia. Presence of any of 3 ECG<\/jats:styled-content> abnormalities had an odds ratio of 7.3 (95% CI<\/jats:styled-content>: 2.9\u201018.1) for cardiac tamponade.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In malignant PE<\/jats:styled-content>, combination of ECG<\/jats:styled-content> abnormalities can supplement clinical examination in the diagnosis of echocardiographic cardiac tamponade. Due to its low NPV<\/jats:styled-content>, 12\u2010lead ECG<\/jats:styled-content> cannot be used as a screening tool to exclude cardiac tamponade with malignant PE<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22370","type":"journal-article","created":{"date-parts":[[2015,2,18]],"date-time":"2015-02-18T16:09:35Z","timestamp":1424275775000},"page":"139-144","source":"Crossref","is-referenced-by-count":33,"title":["Role of a 12\u2010Lead Electrocardiogram in the Diagnosis of Cardiac Tamponade as Diagnosed by Transthoracic Echocardiography in Patients With Malignant Pericardial Effusion"],"prefix":"10.1002","volume":"38","author":[{"given":"Rahul G.","family":"Argula","sequence":"first","affiliation":[{"name":"Department of Cardiology University of Texas MD Anderson Cancer Center Houston Texas"},{"name":"Division of Pulmonary, Critical Care, Allergy and Sleep Medicine Medical University of South Carolina Charleston South 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