What is value of ECG and Echocardiography in High blood Pressure Diagnosis
In high blood pressure patients, ECG may show left ventricular hypertrophy (a poor prognosis sign). An apical S4 gallop due to decreased left ventricular compliance, is frequently heard in the presence of loud sound over the aortic area. There may also be an aortic systolic murmur and on occasion a “functional” diastolic murmur of aortic regurgitation caused by dilatation of aortic ring (which may lessen in intensity or even disappear coincident with reduction in blood pressure from High blood pressure Treatment). These auscultatory sounds and murmurs can be the earliest clinical findings detected in patients with hypertensive heart disease and often presede ECG and other signs of left ventricular hypertrophy. As left ventricle becomes more evident a palpable sustained left ventricle lift may be evident, when the left ventricle can adapt no further to an increase in after-loard, an S3 gallop appears on clinical examination, denoting the presence of Left ventricular systolic dysfuntion.
Ecocardiography is of particular value to know the progression of cardiac involvement in a high blood pressure patient. Ecocardiography also helps in finding out the structural and functional effect of antihypertensive drugs treatment on left ventricle mass, wall thickening and fuction. Although Doppler Echo may detect hemodynamically insignificant aortic regurgitation in 10 to 20% of patients, its primary role is in the evaluation of patient with clinical symptoms and signs of heart disease.