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韓國人 心電圖에 關한 硏究 (第Ⅲ篇) (第二回 軍陣醫學協會總會宿題報告)

THE ELECT1OCARDIOCItAPHIC STUDY ON KOREANS (Ⅲ)

항공의학 1955년 3권 6호 p.14 ~ 36
서순규,
소속 상세정보
서순규 (  ) - 공군 항공의학연구소

Abstract


Factors causing variations in the electrocadiogram
Some factors of common important in Korea effecting the ECG, such as Smoking, Drugs, Athletic and Exercise were studied on 4 cases.
The effect of somking one Korean cigarette were studied on 4 cases of non-smokers and 16 cases of smokers (10 to 20 cigarettes daily).
Three minutes and 30 minutes after smoking two thirds of a cigarette, electrocardigrams were examined. Three minutes after smoking, the heart rate increased 4 to 24 per minutes in 12 cases and the amplitude of P wave in Standard Leads increased by 0.5 mm in 3 cases. The amplitude of T wave in Lead I and Lead II decreased by 1 to 2 mm in 2 cases c e.or-- -ar and there were no T wave changes in smokers. Thirty, minute- king, heart rate restored in 4 cases
aid in 8 cases the heart rate decreased slightly compared to control rate. The increased P waves and decreased T waves restored. ´These changes were slight and varied within normal limits.
The effect of 20cc intravenous injection of "Salbro" which may contains glucose, sodium salycilate and calcium chloride was studied on 5 cases. There was no changes of, ECG besides slightly reduced heart rate. The effect of 20 cc intraveous injection of 30 calcium, chloride solution was studied on 15 cases of non cardiac patient. ECG was examined 5 minutes and 15 minutes after injection. In case of chronic cor pulmonale, due to bronchial asthma,, the high P2 and P3 wave were decreased and lasted until 60 minutes later. There were 5 cases in which heart rate reduce& 8 to 12 per minutes. The effect of 50% glucose 50cc injection was studied on 15 cases of non cardiac patients and ECG was examined 5 minutes dad 30 minutes after the injection.
There was no changes of ECG on either examination: The effect of digitalis leaves on ECG was studied on 3 cases of non cardiac patient and 4 cases of mild congestive heart failure due to rheumatic mitral valvular disease, who had never taken digital is within one month. Digital is levespowder was given in dosis of 0.1 gm every 4 hours 6 dosis and ECG was examined every 4 hours after the digitalis. medication.
Two cases of non cardiac patient had no ECG changes until 24 hours after , medication. In 3 cardiac patients there were slight variations of P wave either increase or decrease up to 12 hours after medication. After 12 hours, in all 3 cases 1 wave started to decrease and RS-T segment depressed slightly. Twenty four hours after medication, definite digitalis effect on RS-T segment and T wave were observed. This results showed that digitalis effect on ECG made even slight increase of T wave in early stage. 5? D/S 1000cc solution were being given.
In the% case of acute quinine poisoning who was given 1000cc for 40 minutes, ECG showed left venticular strain after infusion. In one case who was given 1000cc solution for 2 hours, T wave inverted in Lead I, Lead II and Vs.. No changes of ECG observed in cases who were given 1000cc solution for 3 hours.
In cases who were given warmed solution as body temperature, T waves became high and broad prominently in V, and V2. These results showed that the rapid infusion of large dosis can cause the stress on left ventricle and the infusion of unwarned large dosis of solution may change the ECG.
Exercised test was studied on 15 cases of normal young adult between 20 and 26
years of ,age, 15 cases of normal old adult between 50 and 60 years of age and 12 cases of cardiac patient. The exercise of deep knee joint bending was given 20 times. at the rate of once per second to young adult and 10 .times to old adult and cardiac patient. In young adult group, the P wave increased in two cases and decreased in two-cases. The R wave decreased 1.5 to 4.0 mm in Lead I and II in 45% of cases. The T wave decreased 0.5 to 4.0 mm in Lead I, II, 111 and V5. The .RST segment elevated about 0.5 mm in Lead I and II. In old adult group, P wave increased in 3 cases and R wave decreased in Lead I, II and V5 I to 4 mm in 35% of cases. RS segment depressed 0.5 to 1.5 mm in Lead I and 1T wave decreased 1- to 1.5 mm in Lead I. II in 3 cases and P wave prolonged in 4 cases 0.02 to 0.04 second. The R interval prolonged 0.02 second in 4 cases. R waves , in Lead I, II and V5 decreased 0.5 to 1.0 mm in 42.5% of cases. T wave in Lead I II and Vs decreased 1.0 m in 25 of cases. The RST segment in Lead I and II depressed 0.5 to 1.0 m in 8 cases. Most changes of R and T wave were derived from the right axis deviation due to exercise. These results showed that the changes of ECC after exercise varied with severity and rate of exercise. In cardiac cases, the prolongasion of P wave and P-R interval was peculiar.
Twenty six athletes were studied including 13, cases of professional boxers, 5 cases of weight lifting champions, 6 cases of wrestlers and 2 cases of other sports champions, One of boxers, weight lifters and wrestlers was international Olympic champion. Marked bradycardia was not observed in, all athletes. P waves ware fairly high in 7 cases of boxers and in 3 cases of boxers, P wave were, high more than 2 mi m. Duration of P wave prolonged 0.710 to 0.12 second in 6 cases of boxers, in 4 cases of wrestler and in 2cases of weight lifters. The prolonged P-R interval more than 0.20 second was observed in one case of boxer and weight lifter. The prolonged QRS duration 0:10 to 0.12 second was observed in 2 cases of boxer and in one weight lifter.
The effect of athletic competition on athlete´s ECG was studied. Four cases of CG were examined after 6 round professional boxing match and 8 cases of EGG after malason race (running for about one and half hours). In cases of boxing matches, P wave increased in one case and P-R interval increased 0.02 second in 2 cases despite increased heart rate. In cases of malason races, P2 and P. higher than 2 mm were observed in 5 cases. R2 and R.8 increased in 4 cases and showed right six deviation. But no lowering of T wave and depression of RST segment were observed.
According to these results, the effect of atheletism on ECG were 1.increased P in Lead II and III 2. prolongation of P wave, QRS complex, and P-R interval.
The limits of normal variation after exercise and effects of sports on ECG were discussed.

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