Siegler D
Thorax. 1977 Jun;32(3):328-32. doi: 10.1136/thx.32.3.328.
Previous reports have documented the occurrence of reversible electrocardiographic changes including right axis deviation, P pulmonale, right bundle-branch block, and ST-segment and T-wave abnormalities in patients with acute attacks of asthma. In a further systematic study, the electrocardiographs of 63 patients admitted with severe acute asthma have been evaluated. The most consistent change was an abnormally vertical P-wave axis in 78% of the patients. P pulmonale was present in 22% and right ventricular enlargement in only one patient. Right axis deviation, right bundle-branch block, and rhythm abnormality were not present in any patient. In 11%, ST-segment or T-wave abnormalities suggesting myocardial ischaemia were noted. These abnormalities persisted for up to nine days and were unexplained. Other ECG abnormalities in acute asthma may reflec positional changes of the heart due to overdistension of the lungs. All ECG changes resolved after clinical improvement.
既往报道记录了哮喘急性发作患者出现的可逆性心电图改变，包括电轴右偏、肺型P波、右束支传导阻滞以及ST段和T波异常。在一项进一步的系统性研究中，对63例重度急性哮喘入院患者的心电图进行了评估。最一致的改变是78%的患者出现异常垂直的P波电轴。22%的患者存在肺型P波，仅1例患者有右心室扩大。任何患者均未出现电轴右偏、右束支传导阻滞和节律异常。11%的患者出现提示心肌缺血的ST段或T波异常。这些异常持续长达9天且原因不明。急性哮喘中的其他心电图异常可能反映了由于肺部过度扩张导致的心脏位置改变。所有心电图改变在临床症状改善后均消失。
