Electrocardiographic variations in cases with pulmonary tuberculosis related to anti-tuberculosis therapy

Abstract

Tuberculosis is the major public health concern globally. Cardiovascular involvement was observed in 1-2% of cases with pulmonary tuberculosis. The present study was designed to assess the ECG changes in pulmonary tuberculosis before and after anti-tuberculosis therapy. A total of 90 clinically diagnosed with sputum positive pulmonary tuberculosis cases above 21 years of age were included. Cases with abnormal findings on ECG were advised to echocardiography to detect the exact abnormality / cardiac complication due to pulmonary tuberculosis. Collected data were analysed to compare the ECG changes in pulmonary tuberculosis at the initial diagnosis and follow up for six months. In 60% of cases, the duration of symptoms was less than 6 months and in 40% cases, it was more than 6 months. ECG abnormalities was observed in 65.5% pulmonary tuberculosis cases before commencing anti-tuberculosis therapy, whereas ECG abnormalities were noted in 34.4% of cases after completion of anti-tuberculosis therapy. Sinus tachycardia was observed in pulmonary tuberculosis cases before anti tuberculosis therapy was 42.2% and after 6 months follow up with ATT it was reduced to 11.1%. Sinus tachycardia, QRS axia+900, p wave axis +900, Right side axis deviation and p-pulmonale was the main abnormalities noticed in ECG before the commencement of anti-tuberculosis therapy. The values were reverted back to normal after anti tuberculosis therapy. PT cases with atypical features should be a monitor with echocardiography for early detection of cardiac complications.