Histiocytosis X Cor Pulmonale
Report:
Sinus tachycardia 102/min
Right atrial abnormality
Left atrial abnormality
Right axis deviation +110o
RSR’S’ in V1
Poor R wave progression
Right ventricular hypertrophy
Comment:
Most patients with a trace like this would have emphysema, but cardiac response to pulmonary hypertension of any cause is of course quite stereotyped. Histiocytosis X often presents with a dramatic CXR in still asymptomatic patients, but pulmonary fibrosis and lung destruction follow.
The LAA here (large PTF in V1) may be – and probably is – an expression of right atrial enlargement.
Below (Fig 45a) is a tracing taken two months later (still waiting for the heart-lung transplant), looking unchanged apart from the unusually prominent P waves in V4-6.
If you have any suggestions for or feedback on this report, please let us know.
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