STUDY TO KNOW VARIATIONS AND FREQUENCY OF ELECTROCARDIOGRAPHIC CHANGES IN PATIENTS OF PULMONARY TUBERCULOSIS

Objectives: To monitor the occurrence of several Electrocardiographic (ECG) variations in patients of Pulmonary tuberculosis.Study Design: Descriptive study.Place and Duration of study: This study was directed at the Chest Ward Of Services Hospital lahore from March 2015 to January 2016.Material and Procedures: 50 patients with pulmonary tuberculosis were involved in this study; those patients were excluded who had any other preexisting congenital, valvular, and infective or cardiomyopathy. Detailed history of socio-demographic characteristics with medical appearance were noted after knowledgeable agreement. All essential laboratory exploration and ECG was executed in all cases. Interpretations were noted on proforma. Results: In this study there were 42 (84%) males and females 08(12%) mostly between age from 46-60 years i.e. 24(48%). There were 35(70%) patients who belong to countryside areas and 43(86%) patients from lower economic class. 34(68%) patients were smokers and there was family history of TB in 22(44%) patients. There were 43(86%) patient suffering from fever, 31(62%) with malaise, (56%) with weight loss, 06(12%) with jaundice, 45(90%) were observed with productive cough while hemoptysis was also found in in 34(68%), regarding clinical presentations. pallor was present in 48(96%) patient, 16(32%) had chest pain with shortness of breathing in 27(54%) and 26(52%) with clubbing.On laboratory surveys 50 (100%) was showing sputum culture positive for acid fast bacilli (AFB) with association of AFB positive in morning mucus in 38 (76%), in 27(54%) Hemoglobin levels were found less than 10mg% and in 23(46%) it is more than 10mg %. After first hour, Erythrocyte sedimentation rate (ESR) was less than 50 in only 02 (04%) patient and more than 50 mm in rest of the patients 48 (96%). In 24 (48%) total leucocyte count was observed more than 11000/mm3and it is more than 11000/mm3 in 26 (52%). Pleural effusion in 13 patients was noted and their examination reveals exudate with protein levels more than 3gm/ dl. The patients who had pleural effusion also shows positive coagulum test as well. All patients were found negative for drug resistance on genexpert. (Molecular test) Different electrocardiographic changes were observed in 38 (76%) out of 50 cases in TB patients of different varieties. Sinus tachycardia was seen in 29(58%), P wave changes in 11(22%), P pulmonale in 12 (24%), Low voltage QRS in 19(38%), Left axis deviation in 11(22%) and Right axis deviation 10 in (20%).Conclusion: As cardiopulmonary functions are correlated with one another abnormal changes in one system is reflected on other as well. Out of 50 patients of TB 38 had changes in cardiac functions reflected in ECG. Therefore it is important to diagnose and treat TB as prompt measure for prevention of cardiac complication seen in diagnosed and even in new pulmonary tuberculosis cases. Key Words: ECG, sputum positive, tuberculosi