EFFECTS OF MILD, MODERATE & SEVERE ANAEMIA ON ECG



EFFECTS OF MILD, MODERATE & SEVERE ANAEMIA ON ECG.

Dr. Neha H. Pandya*, Dr. Kinnar S. Desai**, Dr.Shobha Naik***, Dr.Anju Mehta****, Dr. J.M. Jadeja*****

Assistant professor* (Dept of physiology), Assistant professor(Dept of anatomy) **, ***Additional professor(Dept of physiology), ****Additional professor(Dept of physiology), *****Professor & HOD(Dept of physiology)- B.J. Medical College Ahmedabad 380016

Abstract:

India has highest prevalence of nutritional anaemia. Its prevalence is high in women & children. Anaemia results in tissue hypoxia. In anaemia as Hb concentration & RBC count decrease it causes hyperdynamic circulation leading to tachycardia. The abnormalities found in ECG were due to myocardial hypoxia resulting from decreased oxygen carrying capacity of the blood. To overcome myocardial hypoxia various hemodynamic & non hemodynamic mechanisms come to play a role to compensate for anaemia. But in the long term, hemodynamic alterations lead to gradual development of cardiac enlargement & ventricular hypertrophy. So if anaemia remains untreated it may lead to cardiac complications which lead to poor prognosis. This is the reason to study the effect of anaemia on ECG. The subjects for study were 75 men & women. Severity of anaemia was decided by Hb concentration. Study cases were divided according to comparision of severity of anaemia with: ECG changes, age group & ECG changes & type of ECG abnormality. In our study we found abnormality in ST segment & T wave. In this study, we have tried to summarize the effects of anaemia on ECG.

Key words: anaemia, ECG, myocardial hypoxia, preload & afterload.

Introduction

Anaemia is a low Hb concentration due to decreased red cell mass. Hb may get decreased due to dilution of plasma (as in pregnancy), reduced production or increased loss of RBCs & has many other causes.

Anaemia of chronic disease is associated with variety of diseases like infections, collagen vascular diseases, malignancy & renal diseases. Heart is affected according to the degree & severity of anaemia & presence or absence of secondary circulating changes in the body.

Anaemia may lead to increased cardiac output, increased heart rate, vasodilatation & in long term it may lead to cardiac enlargement & left ventricular hypertrophy.

Acute anaemia lowers coronary vascular resistance whereas chronic anaemia enhances formation of intercoronary collaterals & causes increase preload(venous return) & reduction in afterload(peripheral vascular resistance). Gradual development of severe anaemia may lead to cardiac hypertrophy by causing vasodilatation.

In chronic anaemia heart dilates as well as hypertrophies resulting in “fatty degeneration” which occur due to disturbed metabolism of the cells. The pathological changes are maximum in subendocardial layer & particularly of left ventricle. In some cases of anaemia, irreversible damage may occur to heart due to long standing anaemia.

Materials & methods

This study was carried out in 75 patients of anaemia admitted in civil hospital Ahmedabad, Asarva. In all cases detailed history along with clinical examination, laboratory investigations & ECG were carried out.

Hematological investigations done were: Hb concentration & RBC count by optical density & impedence method in a machine called cell counter which provided idea about severity of anaemia.

Electrocardiogram(ECG) is a record made by the machine called the electrocardiograph. It is an instrument for making permanent record of small potential variations which occur in different parts of body due to electrical activity of the heart. ECG had provided guidance to study the effects of anaemia on heart.

Results

Anaemia is classified according to the level of Hb concentration.

Mild anaemia:-Hb:>8-12 gm%

Moderate anaemia:- Hb: 5-8 gm%

Severe anaemia:- Hb: ................
................

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