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Patient
62-year-old woman, smoker, followed for chronic bronchitis, centrolobular emphysema and chronic respiratory failure;
Trace
This tracing shows a sinus rhythm, a biatrial enlargement (right enlargement: voltage > 2.5 mm in lead II, negative P-wave in aVL, and left enlargement: large and deep negative component in V1, bifid P-wave in lead I), a normal PR interval, a prolonged QRS at 115 ms with incomplete right bundle branch block pattern, R/S ratio < 1 in V6, right axis deflection, repolarization disorders (negative T-waves in leads III, aVF, V1 and V2 );
Exergue
Pulmonary emphysema is accompanied by chest distension and a decrease in pulmonary conductivity which impairs the transmission of cardiac potentials. The electrocardiogram typically reveals a pulmonary P-wave, a low QRS voltage, a right axis deviation and a clockwise rotation.
This patient initially presented with chronic bronchitis and emphysema which progressively evolved to chronic respiratory failure.