Abnormal Changes of a 12-Lead Electrocardiogram in Male Patients with Left Primary Spontaneous Pneumothorax.
BACKGROUND
Typical electrocardiographic (ECG) changes associated with left primary spontaneous pneumothorax (PSP) have previously been well-described. However, there were no reports in the literature about the characteristic of ECG in estimating the severity of pneumothorax.


METHODS
From 2003 through 2008, 63 male patients who had left PSP were divided into two groups: 1) large PSP, Light index ≥ 20% (n = 43), and 2) small PSP, Light index < 20% (n = 20). The ECGs of 64 age-matched disease-free men were used as the normal control. Those medical records reviewed that provided data for this study included patient backgrounds, severity of PSP, and 12-lead ECG characteristics.


RESULTS
As compared to the normal controls, left PSP patients had lower body mass index, more rapid heart beat rate and lower voltages in V3R-V6R. In analyzing QRS voltages, the amplitudes of V2S and V3S were significantly different. As with both V2S < 12 mm and V3S < 9 mm, the sensitivity, specificity and positive predictive value to predict patients who had large left PSP area were estimated at 42% (18/43), 100% (20/20) and 100% (18/18), respectively.


CONCLUSIONS
Using the criteria of V2S < 12 mm, V3S < 9 mm and electrical alternans could predict pneumothorax size exceeding 20% in patients who already had left PSP.


BACKGROUND
12-lead electrocardiogram; Male; Primary spontaneous pneumothorax.
Department of Internal Medicine;; Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung;
Shih-Chung
SC
Huang
Department of Internal Medicine;; Department of Internal Medicine, Hualien Armed Forces General Hospital;
Gen-Min
GM
Lin
Department of Public Health, Tzu- Chi University, Hualien;
Yi-Hwei
YH
Li
Department of Internal Medicine;
Chin-Sheng
CS
Lin
Department of Radiology, Tri- Service General Hospital, National Defense Medical Center, Taipei;
Hung-Wen
HW
Kao
Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Chih-Lu
CL
Han