What is it about?
An electrocardiogram (ECG) offers valuable insights into an individual's overall health beyond cardiovascular conditions. Numerous non-cardiac factors can significantly impact ECG readings, resulting in substantial variations in recorded findings. Given that current knowledge in this area remains limited and scattered across different sources, this manuscript seeks to fill the knowledge gap by thoroughly reviewing ECG alterations attributed to diverse non-cardiac factors.
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Why is it important?
The heart, though central to circulation, is not an isolated entity. Its function is intimately linked with all body systems, making the electrocardiogram (ECG) a vital window to broader physiological states. Consequently, ECG abnormalities frequently arise from noncardiac conditions, providing critical insights into systemic health. "Noncardiac Causes of ECG Abnormalities" offers a comprehensive understanding of these diverse ECG changes. This book leverages the latest scientific knowledge and clinical experience to detail how neurological, pulmonary, metabolic, toxicologic, pharmacologic, environmental factors, and even technical issues like electrode misplacement influence ECG readings. Each section is clinically relevant and includes real patient ECG tracings for better illustration. Given the wide range of topics covered and the overlapping nature of some ECG changes between cardiac and non-cardiac causes, it is essential to understand that no single algorithm can definitively differentiate between these causes. The clinical context is always crucial for accurate interpretation. An essential guide for a wide range of medical personnel, this book illuminates the crucial interplay between systemic pathologies and the electrical language of the heart.
Perspectives
Over the past two decades, as a cardiac electrophysiologist, the electrocardiogram (ECG) has been at the centre of my clinical practice. What has continually captivated me are the ECG changes triggered by non-cardiac conditions. From the characteristic Osborn wave in hypothermia to the prognostic clues in tricyclic antidepressant toxicity and the critical patterns of severe hyperkalemia, these findings highlight the ECG’s value beyond heart disease alone. Yet, information on these topics is often scattered. “Non-Cardiac Causes of ECG Abnormalities” brings these conditions together, explaining their mechanisms and illustrating them with real patient examples. In the chapter on electrolyte abnormalities, I have detailed their effects on cellular electrophysiology. The section on electrode misplacement features diagrams to facilitate understanding. Another extensively researched topic is toxins—both natural and synthetic—where I have endeavoured to cover all clinically relevant aspects. I am grateful to my institution, mentors, colleagues, students, and patients, who have been my greatest teachers. I hope this book inspires readers to interpret every ECG with a wider perspective, always looking beyond the heart.
Sirin Apiyasawat
Mahidol University
Read the Original
This page is a summary of: Non-Cardiac Causes of ECG Abnormalities, August 2025, Sciencedomain International,
DOI: 10.9734/bpi/mono/978-81-990550-1-8.
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