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  3. 7. Frequency and Variation of Electrocardiographic Changes Patients of Pulmonary Tuberculosis
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7. Frequency and Variation of Electrocardiographic Changes Patients of Pulmonary Tuberculosis

Aslam Ghouri, Atif Ahmed and Kanwal Abbas Bhatti


Objectives: To determine the frequency of various Electrocardiographic (ECG) changes in patients of Pulmonary tuberculosis.

Study Design: Descriptive study.

Place and Duration of study: This study was conducted at the Institute of Chest Diseases Kotri from June 2016 to December 2016.

Material and Methods: During study period 50 patients with pulmonary tuberculosis were included; patients with any other preexisting congenital, valvular, and infective or cardiomyopathy were excluded. After informed consent detailed history, socio-demographic characteristics with clinical presentation were noted. All necessary laboratory investigation and ECG was performed in all cases. Observations were recorded on proforma.

Results: In this study 42 (84%) males and females 08(12%) mostly in age group of 46-60 years i.e. 24(48%). Most of the patients 35(70%) belong to rural areasand lower economic class 43(86%). In 22(44%) patient there was family history of TB and 34(68%) were smokers.

Regarding clinical presentations all the patient present with fever 43(86%), malaise in 31(62%), weight loss in (56%), jaundice 06(12%), productive cough was observed in 45(90%) while in 34(68%) hemoptysis was also there. Majority of patients present with pallor 48(96%), 16(32%) complains chest pain with shortness of breathing in 27(54%) and clubbing in 26(52%). 

On laboratory investigations 50 (100%) was showing sputum culture positive for acid fast bacilli (AFB) with comparison of  AFB positive in morning sputum in 38 (76%), Hemoglobin levels were found less than 10mg% in 27(54%) in 23(46%) it is above 10mg % . Erythrocyte sedimentation rate (ESR) was<50 in only 02 (04%) rest of the patients 48 (96%) having ESR more than 50 mm after first hour. Total leucocyte count was seen more than 11000 /mm3in 24 (48%) and in 26 (52%) it is more than 11000/mm3. Pleural effusion  in 13 patients was noted and their examination reveals exudate with protein levels more than 3gm/ dl. The patients who had pleural effusion also shows positive coagulum test as well. All patients were found negative for drug resistance on genexpert. (molecular test) Different electrocardiographic changes were observed in 38 (76%) out of 50 cases in TB patients of different varieties. Sinus tachycardia was seen in 29(58%), P wave changes in 11(22%), P pulmonale in 12 (24%), Low voltage QRS in 19(38%), Left axis deviation in 11(22%) and Right axis deviation 10 in (20%).

Conclusion: As cardiopulmonary functions are correlated with one another abnormal changes in one system is reflected on other as well. Out of 50 patients of TB 38 had changes in cardiac functions reflected in ECG. Therefore it is important to diagnose and treat TB as prompt measure for prevention of cardiac complication seen in diagnosed  and even in new pulmonary tuberculosis cases. Key Words: ECG, sputum positive, tuberculosis

Citation of article: Ghouri A, Ahmed A, Bhatti KA. Frequency and Variation of Electrocardiographic Changes Patients of Pulmonary Tuberculosis. Med Forum 2017;28(2):27-30.