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Electrocardiographic screening for emphysema: the frontal plane P axis
1Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01604, USA.
Clinical Cardiology
|March 20, 1999
Summary
Vertical P-wave axis on an electrocardiogram (ECG) effectively screens for obstructive pulmonary disease (OPD). This simple ECG finding demonstrates high sensitivity and specificity for identifying patients with OPD.
Area of Science:
- Cardiology
- Pulmonology
- Diagnostic Medicine
Background:
- Pulmonary emphysema is often associated with a vertical P-wave axis on electrocardiograms (ECGs).
- This ECG finding is considered a sensitive indicator in adults.
Purpose of the Study:
- To evaluate the effectiveness of a vertical P-wave axis as a standalone screening criterion for obstructive pulmonary disease (OPD).
- To assess the diagnostic utility of this ECG parameter in an adult hospital setting.
Main Methods:
- Analysis of 954 consecutive electrocardiograms (ECGs) from an adult hospital population.
- Selection of 100 ECGs with a vertical P axis (>= +70 degrees) and 100 with a non-vertical P axis (<= +50 degrees).
- Correlation of ECG findings with pulmonary function tests and clinical criteria for obstructive pulmonary disease (OPD).
Main Results:
- Obstructive pulmonary disease (OPD) was identified in 89% of patients with a vertical P-wave axis.
- Only 4% of patients without OPD exhibited a vertical P-wave axis.
- The vertical P-wave axis demonstrated high sensitivity (89%) and specificity (96%) for OPD detection.
Conclusions:
- A vertical P-wave axis is a highly sensitive and specific screening criterion for obstructive pulmonary disease (OPD).
- The simplicity of this ECG finding makes it a user-friendly tool for initial OPD screening.
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