[Prognostic significance of ECG changes in acute pneumonia]

A total of 293 patients with acute pneumonia were examined for the relationship between ECG changes and the gravity and immediate outcomes of disease. The pneumonia gravity was determined by the mathematic method based on the computation of the prognostic index of pneumonia (Z. K. Trushinsky et al., 1978). It was established that the overload of the right atrium, malfunction of automatism, excitability and conduction, depression of the ST segment and T wave inversion were in a good agreement with the gravity of pneumonia. In patients with severe and medium-severe disease, the above alterations were more demonstrable than in patients with mild pneumonia. Atrial fibrillation and intraventricular blockades, hypertrophy of the left ventricle and changes in the end part of the ventricular complex were observed more frequently in patients discharged from the hospital with residual phenomena as compared to the recovered patients. This indicates a prognostically unfavourable importance of the ECG signs while evaluating the immediate prognosis. In patients with associated acute pneumonia and coronary heart disease, the ECG changes (arrhythmias, displacement of the ST segment and T wave inversion) were more pronounced and steadier, which was linked with the development of more profound dystrophic lesions of the myocardium.