Gupta P, Jain H, Gill M, Bharaj G, Khalid N, Chaudhry W, Chhabra L. Electrocardiographic changes in Emphysema. World J Cardiol 2021; 13(10): 533-545 [PMID: 34754398 DOI: 10.4330/wjc.v13.i10.533]
Corresponding Author of This Article
Lovely Chhabra, FACC, MD, Doctor, Department of Cardiology, Westchester Medical Center Network Advanced Physician Services, 241 North Road, Poughkeepsie, NY 12601, United States. lovids@hotmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Puneet Gupta, Department of Interventional Cardiology, Northeast Ohio Medical University, Canton, OH 44272, United States
Hitangee Jain, BA-MD, Brooklyn College, Brooklyn, NY 11210, United States
Misbah Gill, Department of Family Medicine, Memorial Hospital of Carbondale, Carbondale, IL 62901, United States
Gurpreet Bharaj, Psychiatry, Loretto Hospital, Chicago, IL 60644, United States
Nauman Khalid, Department of Interventional Cardiology, St. Francis Medical Center, Monroe, LA 71201, United States
Waseem Chaudhry, Lovely Chhabra, Department of Cardiology, Westchester Medical Center Network Advanced Physician Services, Poughkeepsie, NY 12601, United States
Author contributions: Gupta P performed the research and a major contribution to the manuscript draft; Jain H contributed to the manuscript draft, schematic illustrations copyright approvals and minor revisions; Gill M and Bharaj G contributed to draft revisions; Khalid N and Waseem C contributed to the analysis and revisions; Chhabra L conceptualized the project, supervised the research, contributed substantially to the manuscript draft, and performed major revisions.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lovely Chhabra, FACC, MD, Doctor, Department of Cardiology, Westchester Medical Center Network Advanced Physician Services, 241 North Road, Poughkeepsie, NY 12601, United States. lovids@hotmail.com
Received: May 1, 2021 Peer-review started: May 1, 2021 First decision: June 7, 2021 Revised: June 25, 2021 Accepted: September 26, 2021 Article in press: September 26, 2021 Published online: October 26, 2021 Processing time: 172 Days and 15.8 Hours
Abstract
Chronic obstructive lung disease (COPD), predominantly emphysema, causes several thoracic anatomical and hemodynamic changes which may cause changes in various electrocardiographic parameters. A 12-lead electrocardiogram (ECG), which is often a part of routine evaluation in most clinical settings, may serve as a useful screening modality for diagnosis of COPD or emphysema. Our current article aims to provide a comprehensive review of the electrocardiographic changes encountered in COPD/emphysema utilizing published PubMed and Medline literature database. Several important ECG changes are present in COPD/emphysema and may serve as a good diagnostic tool. Verticalization of P-vector, changes in QRS duration, pattern recognition of precordial R-wave progression and axial shifts can be considered some of the most valuable markers among other changes. In conclusion, 12-lead surface electrocardiogram can serve as a valuable tool for the diagnosis of COPD and/or emphysema. An appropriate knowledge of these ECG changes can not only help in the diagnosis but can also immensely help in an appropriate clinical management of these patients.
Core Tip: Chronic obstructive pulmonary disease (COPD) remains a major cause of morbidity and mortality in the United States. With COPD, a timely diagnosis and treatment are crucial to prevent increasing severity. COPD can cause electrocardiographic changes due to factors including lung hyperinflation. These changes can be present on the electrocardiograms of patients without COPD; however, specific parameters not seen in those with COPD will be indicative of other diseases such as congenital heart disease. The present review focuses on the use of 12-lead electrocardiogram with an emphasis on vertical frontal plane P-wave axis, combined with other minor abnormalities, which can aid in the diagnosis of COPD.
