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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006240
  • Reminder of important clinical lesson

At the twisted heart of nicotine addiction

  1. Robert Michael Reed1,2
  1. 1Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
  2. 2Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Robert Michael Reed, rreed{at}medicine.umaryland.edu

This case report reviews the ECG manifestations of chronic obstructive pulmonary disease (COPD). Distinct changes of the P-wave axis, QRS axis and morphology are a direct result of the pathophysiological and anatomical changes associated with COPD. These changes are illustrated in a patient with a history of COPD presenting with hypoxaemia and symptoms of shortness of breath.

Footnotes

  • Competing interests None.

  • Patient consent Not obtained.

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