PMID: 36421Jul 1, 1979

P pulmonale in status asthmaticus

The Journal of Allergy and Clinical Immunology
A F GelbP Schiffman

Abstract

We studied 129 patients during acute, severe asthmatic attacks. Electrocardiograms showed P pulmonale in 49% of patients who had an arterial carbon dioxide tension (PaCo2) greater than or equal to 45 mm Hg and an arterial pH less than or equal to 7.37, whereas P pulmonale was present in only 2.5% of asthmatics who had a PaCO2 less than or equal to 44 mm Hg and a pH greater than or equal to 7.38 (p less than 0.001). P wave and QRS axes were 79 +/- 8 degrees and 80 +/- 20 degrees, respectively, in the presence of P pulmonale. When P pulmonale disappeared, the P wave and QRS axes shifted significantly to the left (p less than 0.001). Electrocardiographic P pulmonale persisted 12 to 60 hr after correction of hypoxemia, hypercapnia, and acidosis. In 7 patients with P pulmonale and respiratory acidosis, cardiac catheterization demonstrated normal artery pressures (PAPs) measured relative to atmospheric pressure. In 12 of these peak inspiratory pulmonary artery transmural pressures (PATPs) were increased. Since increased right heart transumural pressures could result in chamber distention, these data are consistent with the hypothesis that reversible P pulmonale in status asthmaticus is explainable on the basis of markedly negative ti...Continue Reading

Citations

Feb 1, 1985·Clinical Reviews in Allergy·G Kurland, A B Leong
Feb 1, 1985·Clinical Reviews in Allergy·H Don
Jan 1, 1986·The Journal of Allergy and Clinical Immunology·E R McFadden
Jun 17, 2010·Clinical Cardiology·Amir KaykhaVictor F Froelicher
Sep 1, 1987·The Journal of Allergy and Clinical Immunology·J M DrazenA Woolcock
May 1, 1994·Clinical Pediatrics·B JoorabchiM A Khalid
Jan 1, 1982·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·R L Siegel, F J Twarog

Related Concepts

Asthma
Diastolic Blood Pressure
Carbon Dioxide
Electrocardiographic Recorders
Forced Expiratory Volume Function
Heart
Hydrogen-Ion Concentration
Dioxygen
Pulmonary Artery Structure
Total Lung Capacity

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