Abstract
Objective: The objective of this article was to determine the frequency of different electrocardiographic (ECG) abnormalities in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).Design: This is a cross-sectional study.Place and duration: The study was conducted at the medicine department at Civil Hospital Karachi, Pakistan, between November 2018 and May 2019.Method: Both female and male participants aged 18-60 years with acute exacerbation of COPD (as per the operational definition) for more than three days who did not receive any treatment for exacerbation were included in the study. Twelve-lead ECG was recorded (Schiller AG, Baar, Switzerland) for 10 minutes after the supine rest, with a 50 mm/s of paper speed, 10 mm/mV of gain, and filter default settings.Results: In total, 140 participants (male: n = 124 [88.6%] and female: n = 16 [11.4%]) were included the research. The mean age of the participants was 40.43 ± 11.51 years. In terms of severity, 46 (32.95) patients presented with mild, 46 (32.9%) with moderate, and 48 (34.4%) with severe exacerbation. Moreover, 33 (23.65%) participants had ECG abnormalities, i.e., 13 (9.3%) patients presented with right atrial enlargement, and eight (5.7%) with right ventricular hypertrophy. Patients with a longer smoking duration (years) were likely to present with ECG abnormalities.Conclusion: Patients with COPD who had severe acute exacerbation and a long smoking duration have a high prevalence of ECG abnormalities. Hence, ECG may be a valuable tool for detecting ischemic abnormalities among patients with COPD, independent of previously known heart disease, in clinical settings.
Highlights
Chronic pulmonary obstructive disease (COPD) is a common, preventable, and treatable disease characterized by chronic poor airflow
ECG may be a valuable tool for detecting ischemic abnormalities among patients with COPD, independent of previously known heart disease, in clinical settings
Patients with COPD who presented with severe acute exacerbation and long smoking duration had a high prevalence of ECG abnormalities
Summary
Chronic pulmonary obstructive disease (COPD) is a common, preventable, and treatable disease characterized by chronic poor airflow. It is a major global public health issue [1]. COPD ranks fifth in terms of disease burden worldwide and third in terms of mortality worldwide. Low-middle income countries, including Pakistan, face unique challenges in diagnosing and managing COPD, during exacerbations, due to suboptimal and diverse primary care systems [3]. The extrapulmonary manifestations of COPD include cardiovascular diseases, osteoporosis, skeletal muscle dysfunction, metabolic syndrome, depression, and lung cancer [6]. Patients with COPD are at a higher risk for independent cardiovascular morbidity and mortality [7]
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