Two Year Observation of Electrocardiographic Changes in Chest Surgery of Tuberculosis and Their Cardio-Pulmonary Function

Abstract

Electrocardiograms were taken serially for two years in 126 cases which had undergone chest surgery for pulmonary tuberculosis. In 104 cases one year post-operatively a simple cardiopulmonary function tests were carried out. 1.Changes in the electrical position : In each group- lung resection in pu_??_nonary tuberculosis (exclusive of pneumonectomy), corrective thoracoplasty and thoracoplasty-- the number showing vertical position was reduced one week post.operatively. One month after surgery there was a tendency of a gradual increase of the number of cases showing vertical position. 2.Changes in the transitional zone : In each group 60 per cent showed no change regardless of surgery.In those showing changes the shift was toward the operated side in partial resection group and toward the healthy side in thoracoplastic group. 3.Heart shadow and transitional zone : Both showed a tendency of shifting to the same side and in the electrical axis the shift to the right was most common. 4.Post-operative incomplete right bundle branch block and right ventricular overloading : This picture was supposed to appear as a result of right ventricular dilatation due to right ventricular overloading. The changes appeared one week after surgery and showed a tendency of returning to pre-operative condition after 3 to 6 months. In the second group this picture appeared about 3 months after surgery and was seen even after 2 years. The former was generally those cases under the age of 30 years with good post-operative course. The latter cases mostly were those over 40 years of age of those showing some complication and unsatisfactory course. The causes can be listed as pre-and post-operative pleural adhesion, re-expansion of the remaining lung, complications, thoracic disconfiguration and so on. 5.Other changes in the electrocardiogram : P and ST. T changes were seen in partial resection and segmental resection groups. In each group recovery from these changes was seen in majority of the cases after one month. Those which showed continuous P and ST. T changes had complications or unfavorable course of illness. 6.Cardio-Pulmonary Function : Those with partial resection and segmental resection and showing very slight pleural adhesions and good re-expansion of the remaining lung with no post-operative complications showed the best result. The results of rehabilitation were also the same.