Senthur Nambi, P (2008) Study of intraventricular Conduction Disturbances and Left Ventricular Hypertrophy in Patients with Hypertension in Government Royapettah Hospital. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
INTRODUCTION Hypertension is one of the leading causes of morbidity and mortality in the world and will increase in world wide importance as a public health problem by the year 2020 1. It is one of the most common diseases which is easily detectable, readily treatable, often leading to fatal complications if left untreated. Hypertension is a powerful risk factor that increases the likelihood of developing a wide variety of cardiovascular diseases like cerebrovascular accident, coronary artery disease, heart failure, renal insufficiency and peripheral vascular disease. 2 Hypertension causes an increase in left ventricular mass and fibrous tissue resulting in increased stiffness of the left ventricle leading possibly to reduced coronary reserve, silent myocardial ischaemia, abnormal electrophysiological properties of hypertrophied myocytes and conduction disturbances. Electrocardiogram is one of the tests recommended by the Seventh Joint National Committee of hypertension for the initial evaluation of a hypertensive patient 3 . Not only is the Electrocardiogram useful in documenting previously undetected myocardial infarction, myocardial ischaemia and conduction disturbances, but also it is the least expensive and possibly the most cost effective way to diagnose or exclude left ventricular hypertrophy. AIM OF THE STUDY: 1. To study the incidence of intraventricular conduction disturbances in patients with systemic hypertension. 2. To identify the most common type of intraventricular conduction disturbance. 3. To study the incidence of electrocardiographic evidence of left ventricular hypertrophy with or without strain in patients with systemic hypertension. MATERIALS AND METHODS: SETTING: This study was conducted in the Government Royapettah Hospital during the period from February 2007 to September 2007. The patients registered in the hypertension clinic were taken up for the study. STUDY POPULATION: Two hundred and fifty patients were selected randomly and included in the study group and their age ranged from thirty to eighty years. METHOD: A detailed history and a thorough clinical examination was done in all patients. The average of two blood pressure readings recorded five minutes apart in sitting position at two visits separated by a week were taken into account. Standard twelve lead ECG was recorded. Those patients with abnormal ECG were followed up a week later with another ECG. Only patients with persistent ECG abnormalities were taken up for analysis. Intraventricular conduction disturbances and LVH were documented using standard ECG criteria as mentioned above. Routine blood pressure, urine analysis and chest x-ray were taken in all patients Inclusion Criteria: Only patients with history of hypertension for more than a year were taken up for the study. Exclusion Criteria: Patients with clinical and ECG evidence of coronary artery disease, valvular heart disease and congenital heart disease were excluded from the study. Patients with history of diabetes, chronic obstructive airway disease were excluded from the study. Patients with secondary hypertension were excluded from the study. CONCLUSION: This study entitled “The study of intraventricular conduction disturbances and left ventricular hypertrophy in systemic hypertension” included the study of 250 patients of systemic hypertension with the clinical presentation and ECG findings. The following conclusions were derived. 1. The incidence of intraventricular conduction disturbance in systemic hypertension was 10%. 2. LAFB was the most common conduction disturbance in systemic hypertension followed by RBBB and LBBB. LPFB was not observed. 3. The distribution of conduction disturbances were almost equal in males and females. 4. Conduction disturbances were more common in the older age group. 5. The incidence of LVH in systemic hypertension was 17.2%. 6. The incidence of LVH without strain and with strain were 12.4% and 4.8% respectively. 7. Female hypertensives were more likely to have LVH . 8. LVH was more common in the older age group. 9. Patients with conduction disturbances and LVH were more likely to have high BP. 10. The presence of intraventricular conduction disturbances and LVH in hypertensives indicates the need for more vigilant antihypertensive therapy.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | intraventricular Conduction Disturbances ; Left Ventricular Hypertrophy ; Hypertension ; Government Royapettah Hospital. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Mar 2018 12:08 |
| Last Modified: | 10 Mar 2018 12:08 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6122 |
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