Abstract
ECG changes in 40 patients with spontaneous pneumothorax were analyzed. The cases were classified into 6 groups with the side, the degree of collapse and the relationship between the collapsed lung and the chest wall. Standard 12-lead ECGs were taken in acute phase on all cases, and 24 cases were followed up after complete resolution. The acute phase ECGs were compared with the standard ECG parameters of Japanese, and the recovery phase ECGs were compared with those of acute phase.
1) In acute phase, R and QRS in I showed lower tendencies in all groups. Those in III showed higher tendencies in high-degree-collapsed groups of both sides.
2) Q-aVL in high-degree-collapsed groups and q-aVL in low-degree-collapsed groups were likely to be noted in acute phase. After complete resolution, Q or q in aVL noted in acute phase remained unchanged in right pneumothorax, but in left pneumothorax they tended to decrease or vanish in the cases that the collapsed lungs were separated with the chest walls. In left high-degree-collapsed group with adhesion of the lung and the chest wall, Q-aVL appeared after resolution of pneumothorax.
3) In right pneumothorax of acute phase, R and QRS in V5-6 tended to increase. In high degree-collapsed group of same side, T in V1 tended to increase, howerve, S and QRS in V1 tended to decrease.
In left pneumothorax of acute phase, R, T and QRS in V5-6 tended to decrease apparently. In high-degree collapsed group of the same side, R, S, T and QRS in V1 tended to increase.
4) Mean frontal QRS axis in acute phase showed a rightward shift tendency in right highdegree-collapsed group, and showed a leftward shift tendency in left high-degree-collapsed group complicating adhesion of the lung and the chest wall.
5) In left pneumothorax of acute phase, R in V6 tended to be taller than R in V5.
6) Transition zone in the chest leads showed a tendency to be shifted to the left in left pneumothorax in acute phase.
This study suggested that ECG is useful for the diagnosis of pneumothorax and its evaluation of resolution, and that ECG may be helpful for diagnosis of the side, the degree of collapse and the relationship between the lung and the chest wall.
