RESUMO
We investigated whether hospitalized malnourished adults would have longer QTc intervals on their electrocardiograms (ECGs) than non-malnourished adults. Seventy-five consecutive adults hospitalized in the Internal Medicine wards of our teaching hospital were prospectively studied. Main diagnoses, anthropometry, including body mass index (kg/m(2)), ECGs, and simultaneous serum levels of sodium, potassium, magnesium, phosphorus, and calcium were recorded. All QT intervals on ECGs were measured in a semiautomatic image analysis system; and QTc intervals were determined with the Bazett formula. Protein-energy malnutrition (PEM) was diagnosed with body mass index below 18.5 kg/m(2). There was no statistical difference between malnourished (n = 30) and non-malnourished (n = 45) with regard to age (40.7 +/- 18.9 y versus 41.4 +/- 16.2 y), male predominance (66.7% versus 80%), or associated diagnoses. Compared with non-malnourished, malnourished patients had higher percentages of positive C-reactive protein (66.7 versus 23.8%), lower serum levels of albumin (2.51 +/- 0.89 g/dL versus 3.41 +/- 0.74 g/dL) and potassium (3.64 +/- 0.65 mEq/L versus 4.12 +/- 0.65 mEq/L), and increased QTc lengths on ECGs (0.423 +/- 0.033 ms versus 0.396 +/- 0.031 ms). Malnourished adults hospitalized in general clinical wards are more likely to have longer QTc intervals on their ECGs, a phenomenon possibly linked to malnutrition and associated electrolyte disturbances.
Assuntos
Eletrocardiografia , Distúrbios Nutricionais/fisiopatologia , Adulto , Índice de Massa Corporal , Proteína C-Reativa/análise , Eletrólitos/sangue , Feminino , Hemoglobinas/análise , Hospitalização , Humanos , Masculino , Distúrbios Nutricionais/complicações , Potássio/sangue , Estudos Prospectivos , Albumina Sérica/análiseRESUMO
PURPOSE: To assess the prevalence of main electrocardiographic alterations in chagasic patients at University of Triângulo Mineiro Medical School, and compare such alterations between aged and non-aged patients. METHODS: Electrocardiograms (ECG) of 2,000 chagasic patients were interpreted. Age, color, sex and concomitant systemic hypertension, congestive heart failure (CHF) and megaesophagus and/or megacolon were registered. Chi-square test was employed to compare aged (60 years or more; n = 378) and non-aged (age less than 60 years; n = 1622) chagasics. RESULTS: ECG were normal in 9.6% of the patients. The main alterations were: ventricular premature complexes (VPC) 42.2%, left ventricular enlargement (LVE) 38.8%, right bundle branch block (RBBB) 32.4%, left anterior hemiblock 29.2% and ventricular repolarization changes 28.2%. The aged group exhibited greater (p < 0.05) proportion of male patients (1.7:1 vs 1.1:1), white than non-white (3.6:1 vs 2.2:1) and larger percentages (p < 0.01) of systemic hypertension (18.2 vs 7.5) and CHF (26.4 vs 12.0). The following alterations were significantly more common on aged chagasic: VPC (62.7 vs 37.5), LVE (43.4 vs 37.1), atrial fibrillation (19.6 vs 5.5), supraventricular premature complexes (11.9 vs 5.2), electrically inactive zone (9.5 vs 6.6), wandering atrial pacemaker (4.5 vs 2.2) and 2nd-degree atrioventricular (AV) block (2.9 vs 1.5). The non-aged chagasic had greater percentage (p < 0.05) than aged group of normal ECG (10.7 vs 5.0), RBBB (34.1 vs 24.9) and 1st degree AV block (9.7 vs 6.3). CONCLUSION: There was a high prevalence of ECG alterations in chagasic patients seeking medical attention. The different frequencies of those alterations between aged and non-aged chagasic may result of conditions more frequently seen in aged, like ischemic heart disease, CHF and systemic hypertension or to a probable more severe cardiac denervation in non-aged chagasic.
Assuntos
Doença de Chagas/fisiopatologia , Eletrocardiografia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Doença de Chagas/complicações , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores SexuaisRESUMO
Os autores descrevem um caso de hipocalcemia mais ICC, em paciente adulto, com comprovacao bioquimica, eletrocardiografica e radiologica. A insuficiencia cardiaca congestiva mostrou-se refrataria a medicacao digitalica, respondendo prontamente a terapeutica com calcio e vitamina D. Chamam a atencao para a importancia da dosagem do calcio serico nas miocardiopatias de causa desconhecida