A Study of ECG and Echocardiographic Findings in Chronic Obstructive Pulmonary Disease Patients in a Tertiary Care Hospital

ABSTRACT

COPD has considerable effects on cardiac functions. Most of the increased mortality and morbidity associated with COPD is due to cardiac involvement. We wanted to assess the electrocardiographic and echocardiographic findings in COPD, correlate these findings in assessing the severity and duration of the disease, analyse these findings in assessing right ventricular dysfunction and compare the results of clinical, electrocardiographic and echocardiographic findings in detecting right ventricular dysfunction in COPD. METHODS50 COPD patients fulfilling the inclusion criteria were recruited. They were staged by PFT and evaluated by ECG and echocardiography. Statistical analysis of correlation was done, and statistical significance was taken as p < 0.05. RESULTSAmong the total of 50 cases selected for study 80 % were males, 20 % were females. On the basis of GOLD guidelines there were 8 %, 44 %, 36 %, 12 % mild, moderate, severe and very severe COPD cases respectively. Symptoms at presentation were cough with sputum (92 %), breathlessness (96 %), swelling of feet (24 %), fever (16 %), and decreased urine output (4 %). Physical signs at presentation were tachypnoea (68 %), loud P2 (24 %), parasternal heave (20 %), raised JVP (24 %), pedal oedema (16 %) and ascites (4 %). ECG findings analysis were P-pulmonale (46 %), RAD (38 %), RVH (34 %), low voltage complexes (30 %), poor progression of r-wave (30 %) and incomplete RBBB (12 %). Correlation of all the above ECG findings showed statistical significance (p < 0.05) with disease severity and disease duration (p < 0.05). Echocardiographic findings were pulmonary hypertension (50 %), Cor pulmonale (44 %), RV dilatation (44 %), RA dilatation (32 %), RVH (24 %), interventricular septal motion abnormality (14 %), LVDD (16 %), LVSD (4 %) and RVSD (4 %). All the above echocardiographic findings of RV dysfunction i.e. PAH, Cor pulmonale, RA dilatation, RVD, RVH and RVSD were statistically significant with disease severity and duration (p < 0.05) along with LVDD, LVSD. CONCLUSIONSThis study emphasises on early cardiac screening of all COPD patients which will be helpful in the assessment of the prognosis and will further assist in identifying the individuals likely to suffer increased morbidity and mortality.