Abstract
ECGs taken from patients with chronic obstructive pulmonary disease (COPD) frequently mimic myocardial infarction (MI), and may, therefore, cause diagnostic difficulties for the physician. In many previous studies, criteria to differentiate electrocardiographically between COPD and MI were either untested in large numbers of cases or too complicated for routine use. This study was undertaken to find simple new criteria, using scalar measurements which are easily obtainable in clinical practice. To assure the stability and repeatability of our results, the accuracy of these criteria was tested in a large series of cases. Three-hundred and ninety-six (396) cases of COPD and eight-hundred and seventy-eight (878) cases of MI comprised the material for this study. The COPD cases were grouped into two: a training set of 266 cases and a test set of 130 cases. There were three MI subgroups: AMI-344 cases, PDMI-449 cases, and LMI-85 cases. By applying the proposed ECG criteria specifically on the "COPD-MI mimics," we were able to reduce the number of potentially misdiagnosed COPD cases (based purely on Q-wave abnormality) from 158 cases (40% of all COPD cases) to 71 cases (18%).
| Original language | English (US) |
|---|---|
| Pages (from-to) | 173-180 |
| Number of pages | 8 |
| Journal | Journal of Electrocardiology |
| Volume | 13 |
| Issue number | 2 |
| DOIs | |
| State | Published - 1980 |
| Externally published | Yes |
Bibliographical note
Funding Information:Changes in the ECG caused by chronic obstructive pulmonary disease (COPD) may resemble those that are due to myocardial infarction ~-3 to such a degree that grossly erroneous interpretations may be made. Although this problem is generally known, the frequency with which it is encountered is not. Coronary artery disease often complicates the course of the patient with COPD and the clin- Washington, D.C. and Minneapolis, Minnesota and the Departments of Clinical Engineering and Medicine, George Washington University, Washington, D.C. *VAMC Minneapolis, Minnesota Supported by the Medical Research Service of the Veterans Administration and Research Grants HL 15047 and HL 16403 from the Heart, Lung and Blood Institute, National Institute of Health, Bethesda, Maryland. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. w 1734 solely to indicate this fact. Reprint requests to: Emigdio A. Lopez,M .D., VA Medical Center, Department of Clinical Engineering and Medicine (151S), 50 Irving Street, N.W., Washington, DC 20422.