The Recognition of Coronary Heart Disease in the Presence of Pulmonary Disease

Rees, H.A.; Thomas, Arthur J.; Rossiter, C. E.

doi:10.1136/hrt.26.2.233

Cited by 23 publications

(8 citation statements)

References 9 publications

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“…The presence or absence of P pulmonale proved to be a correct index of the presence or absence of right ventricular hypertrophy in 13 out of 21 cases (62%), and similarly electrocardiographic signs of 'right ventricular hypertrophy' in the chest leads were correct in 66% of cases. This degree of accuracy in the electrocardiographic detection of an enlarged right ventricle is similar to that of other studies (Fulton, 1953;Rees, Thomas, and Rossiter, 1964;Padmavati and Raizada, 1972). Cases where the electrocardiographic changes and the right ventricular weight do not correspond may well be due to the fact that overdistension of the right ventricle may cause changes in the electrocardiogram although there is no increase in the weight of the ventricular muscle (Burrows et al, 1964).…”

Section: Discussionsupporting

confidence: 85%

A clinicopathological study of fatal chronic airways obstruction.

Scott¹

1976

Thorax

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Scott, K. W. M. (1976). Thorax, 31,[693][694][695][696][697][698][699][700][701]. A clinicopathological study of fatal chronic airways obstruction. A clinicopathological study of 21 patients who died as a result of chronic airways obstruction was carried out. Thirteen patients had been in right ventricular failure for at least one year before death and the other eight patients did not have right ventricular failure. The patients with long-standing right ventricular failure died at a younger age, on average, than those without failure. There were no significant quantitative differences between the two groups in the length of history of chest disease, blood gas estimations, respiratory function tests or degree of polycythaemia. The group with right ventricular failure had significantly larger mean right and left ventricular weights than the group without failure, but there were no significant differences in amounts of emphysema, size of bronchial mucous glands, proportion of small airways lumen in the lung or number of thick-walled peripheral lung vessels between the two groups.The findings did not support the division of this series of patients, with fatal chronic airways obstruction, into two distinct groups broadly defined as 'emphysematous' and 'bronchitic', either clinically or pathologically. A history of right ventricular failure correlated well with the finding of right ventricular hypertrophy at necropsy. Electrocardiographic evidence of right ventricular hypertrophy was found to correspond with the size of the right ventricle at necropsy in 66% of cases. The radiographic diagnosis of emphysema proved an accurate assessment when compared to the necropsy findings, and radiographic estimations of right ventricular enlargement were accurate in 65% of cases.Histological evidence of acute bronchitis was present in 20 of the 21 patients (95%), and five patients showed histological evidence of minor pulmonary thromboembolism. Ten patients in the series showed an increase in the weight of the left ventricle as well as the right ventricle.

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Section: Discussionsupporting

confidence: 85%

A clinicopathological study of fatal chronic airways obstruction.

Scott¹

1976

Thorax

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“…Patients with COPD frequently had congestive heart failure (CHF) during hospitalization (25.8% vs 15.7%, P = 0.001), with no statistical difference in cardiogenic shock, inhospital mortality rate, stroke, or reinfarction. COPD patients had longer hospital stays than non-COPD patients (7 days [4-8] vs 6 days [3][4][5][6][7], P = 0.001), and in the STEMI group the incidence of major bleeding complications was higher in the COPD group (2.8% vs 1%, P = 0.04), despite the fact that these patients were less likely to receive thrombolytic therapy.…”

Section: In-hospital Treatment and Outcomementioning

confidence: 84%

“…[1][2][3][4][5][6] In a recent large cohort of nearly 400 000 veterans with COPD admitted to a Veterans Administration (VA) hospital, the prevalence of coronary artery disease (CAD) was 33.6%, significantly higher than the prevalence seen in a matched cohort without COPD (27.1%). 7 Other investigators confirmed the high prevalence of CAD in patients with COPD.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Prognosis of Chronic Obstructive Pulmonary Disease Among 8167 Middle Eastern Patients With Acute Coronary Syndrome

Hadi

Zubaid²,

Mahmeed

et al. 2010

Clinical Cardiology

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Background: The purpose of this study was to report the prevalence and the significance of clinically recognized chronic obstructive pulmonary disease (COPD) during acute coronary syndrome (ACS). Hypothesis: COPD in patients with ACS is associated with worse outcome. Methods: Data were derived from a prospective, multicenter, multinationalstudy of 8167 consecutive patients hospitalized with ACS from February to June 2007 in 6 Middle Eastern countries. Data were analyzed according to the presence or absence of COPD. Demographic, management, and in-hospital outcomes were compared. Results: The prevalence of COPD was 5.3%. When compared with non-COPD patients, COPD patients were older and more likely to have diabetes, hypertension, and dyslipidemia. Atypical presentations were more common in COPD patients (P = 0.001). COPD patients were less likely to be treated with thrombolytic therapy (P = 0.001), β-blockers (P = 0.001), and glycoprotein IIb/IIIa inhibitors, and more likely to receive angiotensin-converting enzyme (ACE) inhibitors. Although there was no difference in in-hospital mortality between the 2 groups, patients with COPD were more likely to have heart failure (P = 0.001). Despite the fact that COPD patients with ST-segment elevation myocardial infarction were less likely to receive thrombolytic therapy, they suffered more bleeding complications (2.8% vs 1%, P = 0.04), resulting in prolonged hospitalization. COPD was not an independent predictor of increased in-hospital mortality. Conclusions: In this large cohort of patients with ACS, the prevalence of COPD was 5·3%. Atypical presentation is common among COPD patients, and this may result in delayed therapy. ACS in COPD patients was associated with higher risk of heart failure and major bleeding complications without increased risk of in-hospital mortality.

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“…He also noted that a QRS frontal plane axis of + 91 degrees to + 180 degrees was the most reliable electrocardiographic sign of excessive right ventricular weight but that in the presence of left ventricular hypertrophy or myocardial ischaemic patterns, the electrocardiogram was of little value in diagnosis. On the other hand, Rees, Thomas, and Rossiter (1964), using thickness of the right ventricular wall greater than 5 mm. as an index of right ventricular hypertrophy, showed good electrocardiographic separation between coronary artery disease and pulmonary disease confirmed at necropsy.…”

Section: Resultsmentioning

confidence: 99%