ELECTROCARDIOGRAPHIC STUDY ON THE SIGNIFICANCE OF CHEST PAIN IN PATIENTS WITH ACUTE ASTHMATIC ATTACK

Abstract

Background: Patients with acute asthma are usually presented with dyspnoea, wheezing and cough, but some are presented with chest pain, which is usually overlooked. The pain may be part of the clinical features or due to associated ischaemic heart disease.Objective: To assess the origin of chest pain in acute asthmatic patients.Methods: Tow hundred patients with acute asthmatic attacks were studied for their symptoms and those with chest pain were especially selected and studied by Electrocardiography (ECG) with other investigations. ECG was done on admission and repeated 48 hours later.Results: Thirty cases out of the total 200 with acute asthma were found to have chest pain [15%] as alone or part of the clinical features. The cases with chest pain were commoner in patients older Than 50 years [80%]. ST depression and T wave inversion were the most common abnormalities to be found in cases with chest pain [67%]. After 48 hours some of the ECG changes return back to normal and the remaining cases with ECG changes were [40%] which was considered as a substantial ischaemia.Conclusion: It appears that chest pain occurring in some of the acute asthmatic cases may be due to ischaemia rather than only as a apart of the clinical presentation and it is recommended to be investigated by repeated ECG in all cases.Key words: Asthma, Chest pain ,Ischaemic heart disease