Changes in electrocardiographic findings after closed thoracostomy in patients with spontaneous pneumothorax

Clin Exp Emerg Med. 2017 Mar 30;4(1):38-47. doi: 10.15441/ceem.16.154. eCollection 2017 Mar.

Abstract

Objective: We aimed to describe electrocardiographic (ECG) findings in spontaneous pneumothorax patients before and after closed thoracostomy.

Methods: This is a retrospective study which included patients with spontaneous pneumothorax who presented to an emergency department of a tertiary urban hospital from February 2005 to March 2015. The primary outcome was a difference in ECG findings between before and after closed thoracostomy. We specifically investigated the following ECG elements: PR, QRS, QTc, axis, ST segments, and R waves in each lead. The secondary outcomes were change in ST segment in any lead and change in axis after closed thoracostomy.

Results: There were two ECG elements which showed statistically significant difference after thoracostomy. With right pneumothorax volume of greater than 80%, QTc and the R waves in aVF and V5 significantly changed after thoracostomy. With left pneumothorax volume between 31% and 80%, the ST segment in V2 and the R wave in V1 significantly changed after thoracostomy. However, majority of ECG elements did not show statistically significant alteration after thoracostomy.

Conclusion: We found only minor changes in ECG after closed thoracostomy in spontaneous pneumothorax patients.

Keywords: Electrocardiography; Pneumothorax; Tension pneumothorax.