Clinical Profile of Patients with Chronic Obstructive Pulmonary Disease with Special Reference to Echocardiographic Finding

Background: Chronic obstructive pulmonary disease (COPD) is one of the major respiratory diseases causing high morbidity and mortality worldwide. The widespread use of tobacco and other tobacco products have increased its incidence. There are various patterns seen in the radiography and echocardiographic picture in the patients suffering from COPD. This study aims to know the various radiological and echocardiographic characteristics in these patients and compare the effectiveness of electrocardiogram and echocardiography in detecting the various cardiovascular changes in patients with COPD. Method: This study was conducted in ESIC PGIMSR and Model hospital Basaidarapur in Medicine department. A total of 60 patients were selected who fulfilled our inclusion criteria. Results: In our study out of total 60 cases 46 were males and 14 were females.38 patients were suffering from chronic bronchitis and 22 patients were suffering from emphysema. The majority of patients were farmers, labourers and housewives. In the present study, arrhythmias were found in 3 patients out of total 60. In the present study, P wave abnormalities in the form of P pulmonale was present in 13 (21.7 %) patients out of the total 60 and more common in case of chronic bronchitis (31.6%) than with emphysema (4.5%). Low voltage QRS complexes were seen in 21 cases (35%) of cases and were present in 9 cases of chronic bronchitis (23.7 %) and 12 cases of emphysema (54.5%). Clockwise rotation of heart was found in 11 cases (11.3%) and was higher in cases of emphysema (22.7% vs.15.8%). Echocardiographic abnormalities were found in as many as 56 patients (93.3%) and it was higher among patients with emphysema than with chronic bronchitis (94.5% vs.92.9%). Left ventricular diastolic dysfunction was found in 6 cases (10%) and was more common in chronic bronchitis than with emphysema (10.5% vs.9.1%). In the present study out of the total 60 patients 5 (8.33%) were found to have pericardial effusion. In the present study, 5 cases were found to be having co-existent dilated cardiomyopathy, which was statistically insignificant (p=0.643) and 11 patients had diminished LV ejection fraction (less than50%) suggesting a systolic LV dysfunction, of which 5 had dilated cardiomyopathy. Conclusion: Echocardiographic as well as ECG findings were found in most of the patients suffering from chronic bronchitis and emphysema.