Unreliable electrocardiographic assessment of hemodynamic changes after correction of ventricular septal defect with pulmonary hypertension

Abstract

Electrocardiographic findings were correlated with hemodynamic changes after surgery in 21 patients with ventricular septal defect and pulmonary hypertension. The results of the study show a lack of reliability of the electrocardiogram in assessing hemodynamic changes after surgical correction of hypertensive ventricular septal defects. Although the postoperative electrocardiogram may show regression of right ventricular hypertrophy, mean pulmonary arterial pressure may be normal or elevated. Conversely, in spite of increasing right ventricular hypertrophy shown by electrocardiogram, pulmonary arterial pressure decreased in all patients and total pulmonary resistance decreased in the majority. The persistence of right ventricular hypertrophy as indicated by electrocardiogram, in the presence of normal or near normal hemodynamic data in the postoperative period, may reflect hyperreactivity of the pulmonary vascular bed to the stresses of exercise or the hypoxia of sleep, or both.