Primer spontan pnömotoraksta elektrokardiyografik değişiklikler
Küçük Resim Yok
Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada primer spontan pnömotoraks olgularındaki elektrokardiyografik (EKG) değişiklikler değerlendirildi.Çalışmaplanı:Primer spontan pnömotorakslı toplam 48 hasta (42 erkek, 6 kadın; ort. yaş: 29.7±12.5 yıl; dağılım 15-58 yıl) Kasım 2010 - Kasım 2011 tarihleri arasında prospektif olarak incelendi. Pnömotoraks alanı Rhea metodu ile hesaplandı. Her hastaya en az iki kere standart 12 derivasyonlu EKG çekildi (pnömotoraks tanısından sonra ve göğüs tüpü uygulamasından önce - EKGpnömotoraks ve akciğerin yeniden ekspanse olması ve radyolojik olarak doğrulanmasından sonra - EKGre-ekspanse). P dalgası ölçümü, PR mesafesi, QRS mesafesi, QT intervali ve kalp hızı için düzeltilmiş QT aralığı (QTc) hesaplandı. Ayrıca kalp hızı (dakikada nabız sayısı), aks deviasyonu ölçümleri ve prekordial derivasyonlarda QRS amplitüdleri hesaplandı.Bul gu lar: Pnömotoraks hastaların 29'unda (%60.4) sol, 19'unda (%39.6) sağ hemitoraksta idi. Pnömotoraks alanının ortalaması %43.0±21.5 idi. En sık görülen semptomlar, 34 hastada (%70.8) göğüs ağrısı, 14 hastada (%29.2) nefes darlığı idi. Pnömotoraks süresi 30 hastada (%62.5) <=24 saat iken, 18 hastada (%37.5) >24 saat idi. Tedavi öncesi ve tedavi sonrası QT süresi, aks deviasyonu, kalp hızı, QRSV1, QRSV4, QRSV5 ve QRSV6 değerleri arasında istatistiksel olarak anlamlı bir fark saptandı (sırası ile p=0.001, p=0.023, p=0.001, p=0.010, p=0.046, p=0.000, p=0.008). Üç hastada sağ dal bloku, iki hastada ST yükselmesi ve bir hastada T dalgası sivriliği olmak üzere toplam yedi hastada ilişkili QRS anormallikleri saptandı.So nuç: Çalışma bulgularımız hem sağ hem de sol pnömotoraksın kadınlarda daha belirgin olmak üzere, aks değişikliğine neden olabileceğini ve QRSV 4, 5 ve 6 derivasyonlarında voltajın drenaj sonu arttığını göstermektedir. Ayrıca pnömotoraks sağ dal bloku ve ST değişikliği gibi özellikli EKG değişikliklerine de yol açabilir.
Background: This study aims to evaluate the electrocardiographic (ECG) changes in patients with primary spontaneous pneumothorax. Methods: A total of 48 patients (42 males, 6 females; mean age 29.7±12.5 years, range 15 to 58 years) with PSP were prospectively analyzed between November 2010 and November 2011. Pneumothorax size was calculated using the Rhea method. At least two standard 12-lead ECG were obtained for each patient (after the diagnosis of pneumothorax and prior to drain placement - ECGpneumothorax, and after a complete re-expansion of the lung was achieved and confirmed radiologically - ECGre-expanded). P wave measurement, PR distance, QRS distance, QT interval and QT interval corrected for heart rate (QTc) were calculated. Heart rate (bpm), axis deviation measurement and the QRS amplitudes in precordial leads were calculated. Results: There were 29 cases (60.4%) of left-sided and 19 cases (39.6%) of right-sided pneumothorax. The mean relative volume of pneumothorax was 43.0±21.5%. The most common symptoms included chest pain in 34 patients (70.8%) and dyspnea in 14 patients (29.2%). The pneumothorax duration was <=24 hours in 30 patients (62.5%) and >24 hours in 18 patients (37.5%). There was a statistically significant difference between before and after the treatment for QT duration, axis deviation, heart rate, QRSV1, QRSV4, QRSV5 and QRSV6 (respectively; p=0.001, p=0.023, p=0.001, p=0.010, p=0.046, p=0.000, p=0.008). A total of seven patients had relevant QRS abnormalities including incomplete right bundle branch block in three patients, ST elevation in two patients and T-wave pointedness in one patient. Conclusion: Our study results suggest that left and right lung pneumothorax may cause axis variation, which is more pronounced in women, and that voltage increases after drainage in QRSV 4, 5 and 6 leads. In addition, pneumothorax may lead to specific ECG variations such as right bundle branch block and ST variations.
Background: This study aims to evaluate the electrocardiographic (ECG) changes in patients with primary spontaneous pneumothorax. Methods: A total of 48 patients (42 males, 6 females; mean age 29.7±12.5 years, range 15 to 58 years) with PSP were prospectively analyzed between November 2010 and November 2011. Pneumothorax size was calculated using the Rhea method. At least two standard 12-lead ECG were obtained for each patient (after the diagnosis of pneumothorax and prior to drain placement - ECGpneumothorax, and after a complete re-expansion of the lung was achieved and confirmed radiologically - ECGre-expanded). P wave measurement, PR distance, QRS distance, QT interval and QT interval corrected for heart rate (QTc) were calculated. Heart rate (bpm), axis deviation measurement and the QRS amplitudes in precordial leads were calculated. Results: There were 29 cases (60.4%) of left-sided and 19 cases (39.6%) of right-sided pneumothorax. The mean relative volume of pneumothorax was 43.0±21.5%. The most common symptoms included chest pain in 34 patients (70.8%) and dyspnea in 14 patients (29.2%). The pneumothorax duration was <=24 hours in 30 patients (62.5%) and >24 hours in 18 patients (37.5%). There was a statistically significant difference between before and after the treatment for QT duration, axis deviation, heart rate, QRSV1, QRSV4, QRSV5 and QRSV6 (respectively; p=0.001, p=0.023, p=0.001, p=0.010, p=0.046, p=0.000, p=0.008). A total of seven patients had relevant QRS abnormalities including incomplete right bundle branch block in three patients, ST elevation in two patients and T-wave pointedness in one patient. Conclusion: Our study results suggest that left and right lung pneumothorax may cause axis variation, which is more pronounced in women, and that voltage increases after drainage in QRSV 4, 5 and 6 leads. In addition, pneumothorax may lead to specific ECG variations such as right bundle branch block and ST variations.
Açıklama
Anahtar Kelimeler
Cerrahi, Kalp ve Kalp Damar Sistemi
Kaynak
Türk Göğüs Kalp Damar Cerrahisi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
22
Sayı
3
