2010, Number 2
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Gac Med Mex 2010; 146 (2)
Alteraciones electrocardiográficas en neumotórax izquierdo
Carrillo-Esper R, Garnica-Escamilla MA, Carrillo-Córdova JR
Language: Spanish
References: 8
Page: 157-159
PDF size: 74.30 Kb.
ABSTRACT
Pneumothorax is a frequent complication among patients under mechanical ventilation or undergoing various invasive procedures. Its prevalence in intensive care units ranges from 3% to 14%. The electrocardiographic abnormalities described in left pneumothorax include poor precordial R-wave progression, precordial T wave inversion, phasic QRS voltage variation. QRS voltage ratio (aVF/DI) greater than 2 has high sensitivity and specificity Electrocardiographic changes are secondary to several factors including clockwise rotation axis of the heart, dilated right ventricle, posterior displacement of the mediastinum, hypoxemia, and decreased coronary blood flow. We here describe a patient with left pneumothorax whose electrocardiographic features successfully reversed upon pneumothorax resolving.
REFERENCES
Anzueto A, Frutos-Vivar F, Esteban A, Alía I, Brochard L, Stewart T, et al. Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients. Intensive Care Med 2004;30:612-619.
Lassence A, Timist JF, Tafflet M, Azoulay E, Jamali S, Vincent F, et al. Pneumothorax in the intensive care unit. Anesthesiology 2006;104:1005-1013.
Walston A, Brewer DL, Kitchens CS, Krook JE. The electrocardiographic manifestations of spontaneous left pneumothorax. Ann Intern Med 1974;80:375-379.
Kozelj M, Rakovec P, Sok M. Unusual ECG variations in left-sided pneumothorax. J Electrocardiol 1997;30:109-111.
Monterrubio VJ, Fernández BD, Alzugaray FR, Veiga DM, Córdoba LA, Corcho DG. Elevación del ST y neumotórax a tensión. Rev Esp Cardiol 2000;53:467-470.
Kuriso S, Inoue I, Kawagoe T, Ishihara M, Shimatani Y, Nakama Y. Electrocardiographic findings in left-sided pneumothorax. Am J Emerg Med 2008;26:959-962.
Dimitar R. A case of spontaneous left-sided pneumothorax with ECG changes resembling acute myocardial infarction. Int J Cardiol 1996;56197-199.
Ruo W, Rupani G. Left tension pneumothorax mimicking myocardial ischemia after percutaneous central venous cannulation. Anesthesiology 1992;76:306-308.