From the Guidelines
A patient with a PR interval of 116 milliseconds does not necessarily require a cardiac workup unless accompanied by symptoms or a significant family history of cardiac conditions. The PR interval of 116 milliseconds is at the lower end of the normal range, which is generally considered to be between 120-200 ms. According to the European Heart Journal study 1, a short PR interval without delta waves can be a normal variant in athletes but may also reflect an underlying condition such as ventricular pre-excitation syndrome or structural heart disease. Key considerations for determining the need for a workup include:
- Presence of symptoms like palpitations or syncope
- Family history of pre-excitation, cardiomyopathy, or sudden death
- Other ECG abnormalities, such as delta waves indicative of Wolff-Parkinson-White syndrome In asymptomatic patients without a significant family history, the slight shortening of the PR interval alone is not typically clinically significant. However, if symptoms or a concerning family history are present, a comprehensive evaluation including a complete ECG, echocardiography, and possibly a 24-hour Holter monitor may be necessary to assess for potential underlying cardiac conditions, as suggested by the study 1.
From the Research
Patient Evaluation
- A patient with a PR interval of 116 milliseconds is considered to have a shortened PR interval.
- The provided studies primarily focus on the risks associated with prolonged PR intervals, rather than shortened ones.
Relevant Studies
- None of the studies directly address the risks or recommendations for patients with a shortened PR interval of 116 milliseconds.
- Studies such as 2, 3, 4, 5, and 6 discuss the association between prolonged PR intervals and adverse cardiovascular outcomes, but do not provide guidance on shortened PR intervals.
Clinical Implications
- There is limited evidence to suggest that a shortened PR interval of 116 milliseconds would require a cardiac workup based on the provided studies.
- However, it is essential to consider the individual patient's overall clinical context, medical history, and other electrocardiographic findings to determine the need for further evaluation or monitoring.
- The decision to perform a cardiac workup should be based on a comprehensive assessment of the patient's condition, rather than the PR interval alone.
Further Evaluation
- In the absence of direct evidence, clinicians may need to rely on their professional judgment and consider other factors that may influence the patient's cardiovascular risk.
- Additional research or consultation with a cardiologist may be necessary to determine the best course of action for a patient with a shortened PR interval.