A STUDY ON CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS WITH REFERENCE TO ECHOCARDIOGRAPHIC FINDINGS

BACKGROUNDChronic Obstructive Pulmonary Disease (COPD) is a common and preventable disease, which has great implication on global health.It is acknowledged by WHO as a commonest cause of death worldwide.The major morbidity of COPD is due to its impact on cardiac performance.Right ventricular dysfunction is common in patients with COPD.Echocardiogram is a very simple and convenient bedside investigation to detect cardiac function and structure. OBJECTIVETo study the clinical profile, echocardiographic findings of COPD patients and to correlate the echocardiographic findings with the severity of the disease. MATERIAL METHODA total of 100 patients admitted in the Department of Medicine of Silchar Medical College during the period from June 2013 to May 2014 were selected and detailed clinical examination, pulmonary funtion test, Chest X-Ray, ECG and Echocardiogram were done in all cases. RESULTMean age of the patients was 61+8.6 years and highest 46% were in the age group of 61 to 70 years and 86% were male.Highest number 64% were farmers residing in rural area (83%); 89% of patients were smoker presented with cough (97%), expectoration of sputum (93%) and dyspnoea (91%).The patient had pedal oedema (65%), raised JVP (56%) and cynosis (43%).In 94% pulmonary rales, 79% use of accessory muscle of respiration, 74% ronchi and 52% barrel shaped chest was found.In chest X-ray 49% had chronic bronchitis and another 49% emphysema.Pulmonary function test revealed severe obstruction in 50% and moderate obstruction in 46%.ECG revealed P-Pulmonale (51%), Right axis deviation (45%), RVH (39%) and RBBB (31%).Echocardiogram shows dilated right ventricle (53%), Pulmonary hypertension (53%), right atrial enlargement (42%) and right ventricular hypertrophy (26%).In the moderate severe COPD 32.60% (15 out of 46) had dilatation of right ventricle and pulmonary hypertension.Only 8.69% had right atrial enlargement.In severe group 76% had right atrial enlargement, dilated right ventricle and pulmonary hypertension.Right ventricular hypertrophy was present in 52%. CONCLUSIONFrom the present study, it is concluded that COPD is common in male smoker with rural background in the age group 61 to 70 years age.Main presenting features are chronic cough with expectoration with pedal oedema and raised JVP.Equal no. of patients belonged to chronic bronchitis and emphysema.Right side of heart is affected commonly as detected by ECG and Echocardiography.Echocardiography plays an important role in detecting involvement of right side of heart in chronic obstructive pulmonary disease.