Abstract
The clinical diagnosis of chronic cor pulmonale has not yet been easy. The right heart catheterization is too cumbersome as a routine test, hence the clinical diagnosis of chronic cor pulmonale is usually based on the electrocardiogram using the various electrocardiographic criteria for the estimation of right ventricular hypertrophy. However, these criteria, except one reported by the World Health Organization (hereafter abbreviated as WHO), were set up from the cases with anatomical right ventricular hypertroyhy due to chronic cor pulmonale and others. In this study, the electrocardiograms from 24 cases of autopsy-comfirmed chronic cor pulmonale were analysed in order to evaluate the diagnostic value of various electrocardiographic criteria for the diagnosis of right ventricular hypertrophy due to chronic cor pulmonale. The influence of coexisting hypertrophy on the right ventricular hypertrophy pattern was also examined. Materials and Methods Twenty-four cases employed in this study died at the Keio University Hospital from chronic pulmonary diseases and/or pulmonary dysfunction. At postmortem study, all of them had definite right ventricular hypertrophy and were diagnosed pathologically as chronic cor pulmonale. Right ventricular thickness greater than 4 mm and left ventricular thickness greater than 15mm were defined right and left ventricular hypertrophy, respectively. Combined ventricular hypertrophy was present in 6 of 24 cases. Their age ranged between 25 and 83 years, with an average of 49 years. There were 17 males and 7 females. The underlying diseases were pulmonary tuberculosis (10 cases), chronic pulmonary emphysema (3 cases), pulmonary tuberculosis and chronic pulmonary emphysema (3 cases), bronchiectasis and chronic pulmonary emphysema (3 cases), bronchiectasis (2 cases), pulmonary fibrosis (1 case), pulmonary cyst (1 case), and chronic pulmonary emphysema and pulmonary cancer (1 case). These diagnoses were based on pathological findings.
