Shih-Chung Huang1, Gen-Min Lin2, Yi-Hwei Li3, Chin-Sheng Lin4, Hung-Wen Kao5, Chih-Lu Han6. 1. Department of Internal Medicine;; Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung; 2. Department of Internal Medicine;; Department of Internal Medicine, Hualien Armed Forces General Hospital; 3. Department of Public Health, Tzu- Chi University, Hualien; 4. Department of Internal Medicine; 5. Department of Radiology, Tri- Service General Hospital, National Defense Medical Center, Taipei; 6. Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: Typical electrocardiographic (ECG) changes associated with left primary spontaneous pneumothorax (PSP) have previously been well-described. However, there were no reports in the literature about the characteristic of ECG in estimating the severity of pneumothorax. METHODS: From 2003 through 2008, 63 male patients who had left PSP were divided into two groups: 1) large PSP, Light index ≥ 20% (n = 43), and 2) small PSP, Light index < 20% (n = 20). The ECGs of 64 age-matched disease-free men were used as the normal control. Those medical records reviewed that provided data for this study included patient backgrounds, severity of PSP, and 12-lead ECG characteristics. RESULTS: As compared to the normal controls, left PSP patients had lower body mass index, more rapid heart beat rate and lower voltages in V3R-V6R. In analyzing QRS voltages, the amplitudes of V2S and V3S were significantly different. As with both V2S < 12 mm and V3S < 9 mm, the sensitivity, specificity and positive predictive value to predict patients who had large left PSP area were estimated at 42% (18/43), 100% (20/20) and 100% (18/18), respectively. CONCLUSIONS: Using the criteria of V2S < 12 mm, V3S < 9 mm and electrical alternans could predict pneumothorax size exceeding 20% in patients who already had left PSP. KEY WORDS: 12-lead electrocardiogram; Male; Primary spontaneous pneumothorax.
BACKGROUND: Typical electrocardiographic (ECG) changes associated with left primary spontaneous pneumothorax (PSP) have previously been well-described. However, there were no reports in the literature about the characteristic of ECG in estimating the severity of pneumothorax. METHODS: From 2003 through 2008, 63 male patients who had left PSP were divided into two groups: 1) large PSP, Light index ≥ 20% (n = 43), and 2) small PSP, Light index < 20% (n = 20). The ECGs of 64 age-matched disease-free men were used as the normal control. Those medical records reviewed that provided data for this study included patient backgrounds, severity of PSP, and 12-lead ECG characteristics. RESULTS: As compared to the normal controls, left PSPpatients had lower body mass index, more rapid heart beat rate and lower voltages in V3R-V6R. In analyzing QRS voltages, the amplitudes of V2S and V3S were significantly different. As with both V2S < 12 mm and V3S < 9 mm, the sensitivity, specificity and positive predictive value to predict patients who had large left PSP area were estimated at 42% (18/43), 100% (20/20) and 100% (18/18), respectively. CONCLUSIONS: Using the criteria of V2S < 12 mm, V3S < 9 mm and electrical alternans could predict pneumothorax size exceeding 20% in patients who already had left PSP. KEY WORDS: 12-lead electrocardiogram; Male; Primary spontaneous pneumothorax.