A STUDY OF CORRELATION BETWEEN THE ECG CHANGES WITH THE DURATION AND SEVERITY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in India especially in rural areas. COPD is the 5th leading cause of death worldwide. COPD causes hypoxia in lungs triggering the pulmonary vasoconstriction which leads to increase in pulmonary vascular resistance finally involving the heart and causes right sided cardiac complications which can be evidenced by Electrocardiography (ECG). Therefore, the present study was conducted to evaluate the diagnostic values of ECG changes among COPD patients. MATERIAL AND METHODS: This was a cross-sectional study done in the Medicine department of Chirayu Medical College and Hospital, Bhopal during the period from January 2012 to June 2012. 60 cases of COPD were selected for study. The diagnosis of COPD is based upon the clinical history, clinical examination, X-ray chest and Pulmonary Function Test (PFT). ECG was done in all the 60 patients and looked for heart axis, Right Ventricular Enlargement (RVE), Right Atrial Enlargement (RAE) and Right Bundle Branch Block (RBBB). RESULTS: ECG analysis shows the features suggestive of RAE in >40% of COPD patients having duration of >10 yrs. Out of total 60 patients 24 patients had Forced Expiratory Volume First(FEV1) ≥80% (mild COPD), 30 had FEV1 50 % to 79% (moderate COPD), 5 patients had FEV1 30-49% (severe COPD) and 1 patient had FEV1 < 30% (very severe COPD). When the disease severity is compared with the Manifestations in ECG RAE, RVE and RBBB was found in 3 (60%) of the patients out of 5 patients who had severe disease. CONCLUSION: The prevalence of ECG abnormalities related to cardiac diseases, in general is higher in those with more severe pulmonary obstruction and ECG findings should be taken into consideration when diagnosing these patients of COPD for delivering a more integrated pulmonary and cardiovascular care.