ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Electrocardiographic changes in primary spontaneous pneumothorax
Serpil Sevinç1, Şeyda Örs Kaya1, Şaban Ünsal1, Şahbender Koç2, Timuçin Alar3, Şamil Günay4, Mehmet Böncü5, Hüseyin Candan6
Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Turkey
1Departments of General Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Turkey
2 Department of Cardiology, Hakkari State Hospital, Hakkari, Turkey
3 Department of Thoracic Surgery, Medical Faculty of Çanakkale Onsekiz Mart University, Çanakkale, Turkey
4Department of Chest Surgery, OSM Middle East Hospital, Şanlıurfa, Turkey
5Departments of Department of Chest Disease, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Turkey
6Department of Biostatistics and Medical Informatics, Medical Faculty of Ege University, İzmir, Turkey
DOI : 10.5606/tgkdc.dergisi.2014.9034
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 (QRSV1-6) 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.

Keywords : Electrocardiography; pneumothorax; right bundle branch block
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