Abstract
The purpose of this study is to evaluate clinical significance of electrocardiographic findings in the elderly patients under prolonged bed fast. ECG findings were analyzed and compared with underlying diseases, clinical laboratory data, and pathological findings of the heart in the 124 elderly patients under bed fast over 3 months (Group A), in the 273 subjectively healthy men living in an old-age home (Group B), and in the 112 autopsy cases of the elderly patients died after prolonged bed fast (Group C).
1) Group A was revealed to show ECG abnormalities in 96.8% of the patients, of which the incidence was higher than 76.2% in Group B. 2) The significant ECG abnormalities observed in Group A were low voltage of QRS complex, ischemic ST, T change, left ventricular hypertrophy, and nonspecific ST, T change. Among them, the finding of low voltage was the most significant and specific in Group A and was accompanied with ST, T abnormalities in high incidence (76%). 3) Making a comparison of the patients with low voltage (Group LV) to those without low voltage (Group NLV), none of the findings of age, blood pressure, heart rate, serum protein level, hemoglobin level, and serum electrolyte levels could be specific. 4) The incidence of low voltage increased as the period of bed fast became longer and as the time of the ECG recording became near to the time of death. 5) Congestive heart failure was the most common cause of death in the patients with low voltage in Group C. Pathological findings of the heart of them frequently revealed brown atrophy of the heart muscle, cardiac hypertrophy, myocardial infarction, diffuse fibrosis, and fatty degeneration of cardiac muscle.
These findings indicate that the ECG findings of low voltage is specific in the elderly patients under long bed fast and it may also reflect cardiac impairment of these patients so that it can be a guide of prognosis of these patients.
