| The Electrocardiographic Changes, Particularly of Cor Pulmonale in Far Advanced Pulmonary Tuberculosis and Thoracic Surgery |
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Hyo Keun Lee |
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New York City, Sea View Hospital Commonwealth of Virginia , Piedmonl Sanatorium. |
| 중폐증결핵 급 흉곽수술 환자에 있어서의 심전도상의 변화 -특히 폐심증에 대하여 |
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이효근 |
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| Abstract |
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The term “pulmonary heart disease," usually considered to be synonymous with “ cor pulmonale" and “ heart-lung disease," refers to right strain or hypertrophy with or without failure as a consequence of pulmonary hypertension due to increased resistance to blood flow within the pulmonary circuit.
ln pulmonary tuberculosis, the gradual decrease in the pulmonary vascular bed due to fibrosis,
emphysema, or both, is the major factor in the development of increased pulmonary artery resistance with its sequelae of pulmonary hypertension and right ventricular hypertrophy. Impaired ventilatory function with resultant anoxia, hypervolemia, and polycythemia probably contributes to this syndrome when pulmonary fibrosis and emphysema are severe. Chronic anoxia may cause increased pulmonary artery pressure Increased blood volume in an already reduced pulmonary vascular bed contributes to the devlopment of pulmonary hypertension. Ery throcy -tosis, not always present, increases blood viscoisity, there by increasing resistance to blood flow and elevating pulmonary artery pressure. Extensive destruction of lung parenchyma may interfere with the pulmonary blood flow. Marked retractive changes or marked restriction of one or both lungs by a pleural membrane may be factors in the development of chronic cor pulmonale.
Thoracic surgery in pulmonary tuberculosis such as thoracoplasty or pneumonectomy may embarrass the heart mechanically by pressure or torsion of the pulmonary vessels or may cause impaired respiratory fuction, displacement or distention of the remaining lung, which also contributes to the development of pulmonary hypertension.
This study deals largely with the electrocardiographic changes of right ventricular hypertrophy in far advanced pulmonary tuberculosis and surgically treated pulmonary tuberculosis.
One hundred and eleven unselected pulmonary tuberculosis patients, 56 cases of far advanced long-standing discase and 55 cases in which thoracic surgery had been donc, were studied.
The electrocardiographic evidence of right ventricular hypertrophy was found to be 8. 9 percent in the non-surgical group. and 1. 8 percent in the thoracic surgcry group.
Postoperative changes of the electric axis. electrical position of the heart, transitional zone of the QRS complex, T waves, and P waves were related to a shift or rotation of the heart and the mediastinum following surgery.
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