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Reversal of Electrocardiogram to Normal in Chronic Obstructive Pulmonary Disease With Emphysema

David E. Dines, MD; Thomas W. Parkin, MD
Arch Intern Med. 1967;120(6):721-724. doi:10.1001/archinte.1967.00300050077013.
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IN THE more advanced stages of chronic obstructive pulmonary disease, characteristic electrocardiographic changes of right atrial enlargement and right ventricular hypertrophy frequently develop.1 It is extremely rare to have such a pattern disappear and the electrocardiogram return to normal in chronic obstructive pulmonary emphysema, which so often is slowly progressive. The patient reported herein had typical chronic obstructive pulmonary disease with emphysema, cor pulmonale and right-heart failure, and secondary polycythemia when first seen, but complete return of the ECG to normal occurred in a two-year period with vigorous treatment.

Report of a Case  A 53-year-old white man was examined in June 1964 because of shortness of breath and ankle swelling. He had smoked two packs of cigarettes per day for 37 years. The shortness of breath had developed progressively over a two-year period, and the ankle swelling had begun three months prior to his examination.Physical examination disclosed plethora,


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