Evaluation of Clinically Significant Cardiac Abnormalities in Patients With Normal Electrocardiogram Using Transthoracic Echocardiography

Abstract

Cardiac abnormalities have been suspected and identified using transthoracic echocardiography in patients with normal electrocardiographic results have been reported. It is, however, not clear whether these abnormalities are clinically significant or can lead to a change in clinical management. The aim of this study was to evaluate the prevalence and clinical significance of cardiac abnormalities found in patients with normal electrocardiographic results. Transthoracic echocardiography was conducted on outpatients on referral despite having normal electrocardiographic results. Clinical symptoms were identified, and parameters such as BMI, smoking status, blood pressure, blood glucose levels, and hypercholesterolemia status were evaluated. The data obtained from these parameters were compared with findings of cardiac abnormalities in the patients. Out of 552 patients analyzed with a mean age of 50.53±15.04 years, 412, representing 74%, had abnormalities in their transthoracic echocardiographic reports. The significant majority of active smoking patients (82.2%) had cardiac abnormalities. The major findings were valvular heart disease observed in 123 patients, grade I and II diastolic dysfunction in 85 patients, hypertensive heart disease in 76 patients, and non-significant valve disease reported in 50 patients. The common symptoms included atypical chest pain, shortness of breath, and epigastric pain. Hypertension, hypercholesterolemia, and diabetes mellitus were observed among patients with abnormal transthoracic echocardiographic reports. There is a high prevalence of clinically significant cardiac abnormalities evaluated using transthoracic echocardiography in patients with normal electrocardiographic results. These cardiac abnormalities are associated with symptoms, and cardiometabolic disease hence might warrant a change in clinical management.