The electrocardiogram in chronic bronchitis and emphysema.

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Abstract
An electrocardiographic study has been made of 112 hospital out-patients suffering from chronic bronchitis. Rightward deviation of the P axis occurred in 32 (29%) patients, P pulmonale in 11 (10%), right ventricular hypertrophy in 11 (10%), and left axis deviation in 8 (7%). Less common abnormalities included small secondary r waves in right precordial leads, right and left bundle-branch block, indeterminate mean QRS axes, and S1S2S3 syndrome., Rightward deviation of the Paxis, P pulmonale, and right ventricular hypertrophy were confined to patients with severe airways obstruction, and the presence or absence of widespread emphysema assessed radiographIcally did not appear to influence these electrocardiographic abnormalities. Left axis deviation may be the sole electrocardiographic abnormality and the possible mechanisms concerned are discussed.