All Issues >> 2016 >> Issue-2


title:P-wave Abnormalities in Patients of Stable Chronic Obstructive Pulmonary Disease

Author:Shriharshavardhana S V, Malay Sarkar, Arvind Kandoria, Rameshwar S Negi, Sunil Sharma

Keywords:Chronic obstructive pulmonary disease, ECG, Echocardiography, P-wave axis verticalisation (PWAV)

Type:Original Article

Abstract:Introduction: COPD is a common preventable and treatable disease and a major cause of morbidity and mortality globally. ECG is a very simple, widely available and convenient bedside investigation that can be used to detect various cardiac abnormalities. Electrical activities of the heart are often influenced by COPD. ECG changes like P-wave abnormalities have to be carefully assessed before coming to an inference. Material and methods: The present study was an institutional based prospective study, conducted from July 2014 to June 2015. The study was designed to assess the various ECG abnormalities in stable COPD patients and to determine echocardiography findings in relation to ECG changes. Results: Among the P-wave abnormalities P-wave axis verticalisation (PWAV) was observed in 59(76.6%) patients. Twenty (26%) patients showed negative P-wave in V1, significant-Ptf(P-terminal force) was observed in 3(3.9%) patients. P-mitrale was seen in 18(31.2%), and P-pulmonale in 16 (20.8%) patients. Conclusion: Though not specific, ECG may reveal various functional and structural abnormalities of the heart in relation to COPD like PWAV. PWAV may be the most commonly seen P-wave abnormalities in COPD patients. Echocardiography findings suggest that presence of P-mitrale is not conclusive of left atrial overload in patients of COPD. Echocardiography should be done routinely in all COPD patients to confirm ECG findings and to diagnose pulmonary hypertension, cor-pulmonale and other subclinical cardiovascular co-morbidities like left ventricular diastolic dysfunction.

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