Cardiac involvement in Wilson's disease--an electrocardiographic observation.
BACKGROUND
Wilson's disease is known for its protean manifestations; however electrocardiographic abnormalities have not received much attention.


OBJECTIVE
To evaluate the various electrocardiographic (ECG) changes in patients with Wilson's disease.


METHODS
The resting ECGs of 50 patients with Wilson's disease were systematically analyzed independently by three observers after excluding other causes that could induce ECG abnormalities.


RESULTS
Fifteen patients had at least one abnormality in the ECG. Sinus tachycardia was seen in eight and sinus bradycardia in six. Other abnormalities included: bifid P wave (1), ST elevation (2), ST depression (2), T inversion (4), ventricular premature contraction - VPC (1) and prominent U waves (1). QRS axis, PR interval, QRS complex, R/S amplitude ratio and QT interval were normal in all. Ventricular premature beats were not recorded in any. None had features of ventricular hypertrophy. There was no statistically significant difference in ECG abnormalities with reference to age, gender, duration of illness or treatment, serum copper or ceruloplasmin, and severity of neurological impairment.


CONCLUSIONS
ECG abnormalities are not uncommon in Wilson's disease and are presumably related to an underlying cardiomyopathy due to deposition of copper in heart.
Meenakshi-Sundaram
S
S
Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore.
Sinha
S
S
Rao
M
M
Prashanth
L K
LK
Arunodaya
G R
GR
Rao
S
S
Swamy
H S
HS
Taly
A B
AB
D000293:Adolescent; D000328:Adult; D001919:Bradycardia / Q000209:etiology*; D002648:Child; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006527:Hepatolenticular Degeneration / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013616:Tachycardia, Sinus / Q000209:etiology*