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KMID : 0367419700110010005
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Journal of Korean Pediatric Society
1970 Volume.11 No. 1 p.5 ~ p.12
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Clinical Studies on Diphtheritic Myocarditis
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姜碩哲/Kang, Suk Chul
李純鎔/李庸圭/洪彰義/Lee, Soon Yong/Lee, Yong Kyoo/Hong, Chang Yee
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Abstract
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During the 8 year period; from. Jan_ 1960 to Oct. 1967, 618 cases of diphtheria were admitted to the Department of Pediatrics, Seoul National University Hospital and of the total patients, 51 cases with diphtheritic myocarditis were evaluated clinically.
The results were as follows:
1. The incidence of diphtheria reached its peak during winter season. The peak age distribution ranged from 4 to 8 years.
2. Out of total 618 cases of diphtheria 53 died, showing an over-all mortality of 8.6%.
3. Fifty one (8.3%) of 618 cases developed clinical and electrocardiographic evidence of diphtheritic myocarditis and 28 (55%) cases of them died.
4. The onset of symtoms and signs indicating myocarditis appeared at average eighth day (range 4,14 days) of illness.
5. The most common clinical features in patients with diphtheritic myocarditis were abdominal pain, vomiting and weakness.
6. The most frequently encountered electrocardiographic abnormalities were flattening or inversion of T waves and depression of S-T segment. Any serious conduction disturbance denoted poor prognosis.
7. The serum transaminases, especially glutamic-oxaloacetic transaminase activity were markedly increased in patients with diphtheritis myocarditis compared with those of the control group. Progressive elevation of GOT levels seemed to be coincident with the progression of serious electrocardiographic abnormalities, e.g. conduction disturbance and persistent high titers or steady increase of GOT activity suggested a guarded prognosis.
8. The effect of steroid on the diphtheritc myorirditis was not conclusive in this study and further study with control group in more cases is indicated for the evaluation of the effect of steroid on diphtheritic myocarditis.
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