The Electrocardiographic Diagnosis of Right Ventricular Hypertrophy in Chronic Obstructive Pulmonary Disease

Abstract

This study compares electrocardiographic changes with right ventricular mass rather than thickness of the ventricular wall in 71 patients with an unequivocal clinical and pathologic diagnosis of severe chronic obstructive pulmonary disease. Specific heart chamber weights were determined in all patients. Pathologically, 30 patients had definite right ventricular hypertrophy and 3 probable right ventricular hypertrophy; 20 patients had normal ventricular weights and 18 patients had left ventricular hypertrophy. Using 20 suggested ECG criteria for the diagnosis of right ventricular hypertrophy, 226 ECG's were analyzed. Four criteria were found to be most reliable: S 1 Q 3 pattern, right axis deviation ≧ 110°, S 1 -S 2 -S 3 pattern, and R/S ratio in V 6 ≦ 1.0. These four simple ECG criteria can be used effectively in predicting right ventricular hypertrophy in patients with chronic obstructive pulmonary disease.