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Differential diagnosis of basic electrocardiographic abnormalities

Ary L Goldberger, MD
Section Editor
David M Mirvis, MD
Deputy Editor
Gordon M Saperia, MD, FACC


The electrocardiographic diagnosis of a variety of cardiac diseases, such as ischemia or infarction, pericarditis, and conduction disturbances, is based upon certain characteristic findings. However, none of these findings alone is usually pathognomonic for a particular disease.

This topic presents a series of tables that list the major causes of a number of common findings and abnormalities [1-4]. Their differential diagnosis is discussed in detail in the appropriate topic reviews.

Q waves (table 1)

ST segment elevations (table 2)

Low QRS voltage (table 3)

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Literature review current through: Jul 2017. | This topic last updated: Nov 02, 2016.
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  1. Goldberger AL, Goldberger ZD, Shvilkin A. Goldberger’s Clinical Electrocardiography: A Simplified Approach, 8th ed, Elsevier/Saunders, Philadelphia 2012.
  2. Goldberger AL. Myocardial infarction: Electrocardiographic differential diagnosis, 4th ed, Mosby Year Book, St Louis 1991.
  3. Mirvis DM, Goldberger AL. Electrocardiography. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th edition, Bonow RO, Mann DL, Zipes DP, Libby P (Eds), W.B. Saunders Company, Philadelphia 2012.
  4. Surawicz, B, Knilans, TK. Chou's Electrocardiography in Clinical Practice, 6th ed, W.B. Saunders Company, Philadelphia 2008.