An ominous prognosis in patients with CHD associated with QRS prolongation

Prognosis in 31 patients （29 males, 2 females, mean age 68 years） with coronary heart disease （CHD） associaled with QRS prolongation were evaluated. All patients freguently had attacks of spontaneous angina pectoris. Prolongation of QRS duration before or during acute myocardial infarction （AMI） was found in 12 patients during angina pectoris episodes, in 18 with old myocardial infarction and in one with unstable angina pectoris. The electrocardiogram also showed disappearance or decrease of q and S wave with prolongation of QRS duration in leads Ⅰ, avL, V5, V6 or Ⅱ, Ⅲ, avF. The QRS prolongation was longer than 30% of the preceding QRS in 10 patients, ≥50% in 19 patients, ≥100% in 2 patients. 27 of the 31 patients ended in cardiac death. Other 4 patients were survival. Patients in whom QRS prolongation developed before or during AMI died, 11 of these 12 patients died within first week after AMI. The results show that the prognosis was ominous in the patients with CHO associated with ≥30% of QRS prolongation. Finally, the mechanism of QRS prolongation is discussed briefly.