Right Heart Loading in Patients with Pulmonary Tuberculosis.

Abstract

The authors made a study on the relationshipbetween ECG findings and the results of otherseveral clinical examinations in 80 cases ofpulmonary tuberculosis, and the followingconclusions were obtained.
1. Criteria to judge the presence of right venricularhypertrophy on ECG was showen inTable 1, and in case if at least 2 of the 7 itemsmentioned in Table 1 were present, rightventricular hypertrophy was considered to bepresent in such cases. Observing by the extentof pulmonary lesions by N. T. A. classification, right ventricular hypertrophy was found in 10 of34 far advanced cases (29.4%), 4 of 21 moderatelyadvanced cases (14.3%), and only 1 of 16minimal cases (5.5%). Pulmonary P was foundin 6 of far advanced cases, only 1 of moderatelyadvanced cases, and none of minimal cases.Thus, these right heart loading findings onECG were more frequently seen among advancedcases of pulmonary tuberculosis.
2. Pulmonary ventilatory function was measuredby using Benedict-Roth type respirometer.Among 13 cases with right ventricular hypertrophyon ECG, 1 showed normal ventilatoryfunction, another one showed slight restrictiveimpairment, and other 11 cases showed expiratoryincompetency or combined impairments.Among 40 cases without right heart loadingfindings on ECG, only 7 showed normal pulmonaryfunction, and other 33 cases showed someventilatory impairments. The above resultssuggest that ventilatory function was impairedeven in many cases without any right heartloading findings on ECG, and that ventilatoryimpairments in pulmonary tuberculous patientsare not only restrictive but also expiratory orobstructive in some cases.
3. Hematocrit value was normal in all cases.The fact suggests that polycythemia does notparticipate in right ventricular hypertrophy inthe case of pulmonary tuberculosis.
4. Regarding serum electrolytes, no significantdifference was found between sodium concentrationof normal group and right heartloading group. Pottasium concentration washigher in cases with right ventricular hypertrophy, and on the contrary, chloride concentrationwas slightly lower in cases with rightventricular hypertrophy. It is interesting thatthe above mentioned results coincide well withthe changes found in the case of pulmonaryacidosis, but we must be careful about its interpretation.
5. Total seurm protein and A/G ratio showedno significant correlation with ECG findings.