“Diagnosis of severity of COPD on the basis of electrocardiogram”

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COPD was 86.36%, Specificity 100%, positive predictive
value 100%, negative predictive value 85.7%, Accuracy
92.5%.Statistical calculations was done by Microsoft
excel and Medcal.
Discussion:
Among 40 patients with COPD enrolled in the present
study, mean age of patients was 60.12 years. The
prevalence was higher among Muslims, belonging to
lower socio-economic status, as Muslim population is
dominant in this part of the state. All of the patients were
smokers. In the present study, peaked P-wave i.e.
amplitude more than 2.5 mm, was recorded in 45 % of the
cases with COPD. In Spodicks [10] series, 13.9% of COPD
patients had P-wave equal or greater than 2.5mm. Carid
and Wilcken[11] found incidence of P-pulmonale in 15.5%
of their COPD patients, while Scott et al [12] and Pinto et al
[13] recorded same incidence of 32.7% in their studies.
Our findings are in concordance with Rachaiah. [14]
Agrawal et al have also showed diagnostic value of ECG
in COPD. [15] In present study changes in ECG were
correlated with severe obstruction as out of 22 patients
with severe COPD, 19 had changes in ECG in form of Ppulmonale.
In none of patients with non severe COPD, Ppulmonale
was present. So, there are chances of false
negative but not of false positives in detecting COPD cases
by ECG. If P pulmonale is present it can be concluded that
COPD is severe and patient may be managed accordingly
even if spirometry is not available. If P pulmonale is
present, patients may be started on both inhaled
corticosteroids as well as on inhaled long acting β2 agonist.
In many hospitals in India ECG facilities are available but
spirometry is not available, especially in rural areas which
contribute a large portion of population in India. ECG does
not require cooperation from patient, unlike spirometry. In
India it is often difficult for patients to understand how to
perform spirometry. Even after repeated attempts they are
not able to do it and this can lead to wrong diagnosis. Often
in the setting of ICU or in case of severe COPD, ECG may
be performed but not spirometry.
Indian Journal of Basic & Applied Medical Research; March 2013: Issue-6, Vol.-2, P. 527-530
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- Its relation to ventilatory junction. Am J Card 1962; 10: 5.
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Heart J. 1961; 61: 843.
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& E C G changes in patients with C O P D.Int. J Biol Med Res. 2012; 3 (1) : 1322-26.
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