Symptoms
Fragmented QRS complexes themselves don't produce symptoms. The presence of fQRS is indicative of an underlying heart condition, and the symptoms experienced are those of the underlying condition, such as:
Chest pain (angina)
Shortness of breath
Palpitations
Fatigue
Lightheadedness or dizziness
Syncope (fainting)
Causes
Fragmented QRS complexes are associated with conditions that cause myocardial damage or altered ventricular conduction, including:
Coronary artery disease (CAD), especially after myocardial infarction (heart attack)
Cardiomyopathies (e.g., dilated, hypertrophic, arrhythmogenic right ventricular cardiomyopathy - ARVC)
Myocarditis (inflammation of the heart muscle)
Fibrosis or scarring of the heart muscle due to any cause
Brugada syndrome
Congenital heart disease
Hypertension
Medicine Used
There is no specific medicine to "treat" fQRS complexes directly. Treatment focuses on the underlying heart condition causing the fQRS, which may include:
Antiplatelet drugs: Aspirin, clopidogrel (for CAD)
Beta-blockers: Metoprolol, atenolol (for CAD, cardiomyopathy)
ACE inhibitors or ARBs: Lisinopril, valsartan (for heart failure, hypertension)
Diuretics: Furosemide, hydrochlorothiazide (for heart failure)
Antiarrhythmic drugs: Amiodarone, sotalol (for arrhythmias)
Statins: Atorvastatin, simvastatin (for CAD)
Other medications: Specific to the underlying heart condition.
Is Communicable
Fragmented QRS complexes themselves are not communicable. The underlying heart conditions that can cause fQRS are also generally not communicable. Some exceptions might exist if myocarditis is caused by an infectious agent, but the fQRS is a consequence of the inflammation, not the infection itself.
Precautions
Precautions depend entirely on the underlying heart condition. General precautions might include:
Following prescribed medication regimens.
Adopting a heart-healthy lifestyle: healthy diet, regular exercise, avoiding smoking, and managing stress.
Regular follow-up appointments with a cardiologist.
Avoiding excessive alcohol consumption.
Monitoring blood pressure and cholesterol levels.
Knowing the signs and symptoms of worsening heart condition and when to seek immediate medical attention.
How long does an outbreak last?
Fragmented QRS is not related to outbreaks.
How is it diagnosed?
Fragmented QRS complexes are diagnosed based on a 12-lead electrocardiogram (ECG/EKG). The presence of an RSR' pattern (an additional R wave), notching, or slurring of the R wave or S wave in two contiguous leads is diagnostic. The ECG is then interpreted in the context of the patient's clinical history, other investigations and examination findings to determine the underlying cardiac pathology. Further testing may include:
Echocardiogram
Cardiac MRI
Coronary angiography
Electrophysiological studies
Timeline of Symptoms
Fragmented QRS complexes themselves don't have a timeline of symptoms. The timeline of symptoms relates to the underlying cardiac condition. Example:
Acute Myocardial Infarction: Sudden onset of chest pain, shortness of breath, and potential development of fQRS on ECG during or after the event.
Chronic Heart Failure: Gradual worsening of shortness of breath, fatigue, and swelling in the legs, with fQRS potentially present on ECG.
Cardiomyopathy: Symptoms may develop gradually or suddenly, depending on the type and severity of the cardiomyopathy.
Important Considerations
Fragmented QRS is a marker, not a disease. Its presence indicates a need for further investigation to identify the underlying heart condition.
The clinical significance of fQRS varies depending on the clinical context.
Not all individuals with underlying heart disease will have a fragmented QRS complex on their ECG.
False positive fragmented QRS complexes can occur due to improper lead placement or other technical factors during ECG recording.