It seems apparent that since the use of long term chemotherapy in tile treatment of
pulmonary tuberculosis patients, there has been an increase in the occurence of
complication such as fibrosis, bronchiectasis, emphysema etc. eventually culminating in
pulmonary insufficiency and Cor-pulmonale. From Post-mortem examinations on
pulmonary tuberculosis cases carried out at Sea view Hospital, observations were made
regarding the incidence of corm-pulmonale. In this study, only those cases with right
heart changes that is consider to be due to the disturbance of pulmonary circulation
were included.
The results were as follows:
1) Of 221 cases with pulmonary tuberculosis, 26 cases (11.7%) had right ventricular
hypertrophy and 41 cases (18.5%) had right ventricular cavity dilatation.
2) Both in the right ventricular hypertrophy group and the cavity dilatation group, the
majority of cases wore fifty years and over and had a diagnosis of far advanced
bilateral tuberculosis. However the former had a longer history of tuberculosis and
chemotherapy than the latter.
3) Emphysema was a complicating factor in both group, but the incidence of
bronchopneumonia was higher in the cavity dilatation group than in the ventricular
hypertrophy.
4) In the group with right ventricular hypertrophy, only 4 out of 22 cases had toll R
wave in aVr and V1, while only 2 cases in group B manifested such
findings
5) A diagnosis of cor-pulmonale in pulmonary tuberculosis apparently cannot be made
on electrocardiographic findings alone. One should consider other factors, such as the
duration of illness, duration of chemotherapy, complications and symptomatology.
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