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Patient
63-year-old man with chronic bronchitis, emphysema and chronic cor pulmonale;
Trace
This tracing shows sinus rhythm, right atrial enlargement (voltage > 2.5 mm in lead II), negative P-wave in aVL, peaked and positive P-wave in V1, normal PR interval, narrow QRS, R/S ratio = 1 in V1, R/S ratio < 1 from V2 to V6, extreme right axis deviation (258°);
Exergue
In patients with chronic pulmonary heart disease complicating chronic respiratory disease, it is difficult to distinguish electrical alterations in relation to causal lung disease from those associated with cardiac impairment, particularly in the case of pulmonary emphysema.
Pulmonary hypertension and chronic cor pulmonale are common complications in patients with COPD in chronic respiratory failure.