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KMID : 0367419760170010041
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Journal of Korean Pediatric Society
1976 Volume.17 No. 1 p.41 ~ p.51
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Electrocardiographic Abnormalities in Diphtheric Children
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鄭秉周/Chung, Byong Joo
李東敏/韓東燮/Lee, Dong Min/Han, Dong Sup
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Abstract
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Five hundred and fifty-seven electrocardiograms were taken from 356 cases of diphtheric children admitted to Kyungpook National University Hospital in the period from Jan. 1960 to Dec. 1972.
The findings of electrocardiograms were analyzed on the basis of the conventional methods.
On admission, abnormal findings were noted in 30. 1% percent (107 of 356). Among children revealed normal findings at the first study, 22.8 per cent (23 of 101) were found to be abnormal on the follow-up checks. Thererfoe, the validity of abnormal findings in total was encountered im 36.5 per cent.
In the abnormalities at the first E.C.G., the changes of ST segment and T wave was most often (9.33), next the prolongation of Q-T interval (8.19), and the prolongation of P-R interved in the rate of 3.4 per cent. The various findings cf conduction defect were also noted in 25 cases (7.0%).
The abnormalities of follow-up tracings among children showed normal findings at the first checks were included 9.9 percent (10 of 101) in the prolongation of Q-T interval, 7.9 percent in ST segment and T wave changes, and 9.9 per cent in conduction defects.
It is evident in this study that the abnormal findings increased with the ages of children-checked and no significatcant difference between boys and girls was observed.
The occurrence of abnormal electroc arPio
graFhic findings increased in proportion to the duration-of illness. Of these, almost all of the cases (100 of 107) were revealed abnormalities between_ third and fourteen days of illness.
In the present study, abnormalities according to the clinical types of illness were 34.0 per cent in pharyngeal, 29.3 per cent in pharyngolaryngeal, and 27.7 percent in laryngeal types, in. decreasing order. While, other types such as nasopharyngeal and nasal types were rarely observed.
The abnormalities including ST segment and T wave changes, prolongation of P-R interval a*,d low voltage wave at the follow-up tracings were disappeared relatively early, but the prolongation-of Q-T interval and conduction defects were, more or less, sustained.
In the course of illness, normal sinus rhythm and sinus arrythmia increased from 12.6 to 19.5 and 21.3 to 48.5 per cent, respeotively, while, sinus tachycardia dropped from 44.1 to 14.8 per cent of the examined.
Of a total 356 children, there were 20 deaths (5.6%). Of these, 12 deaths were possibly due-to complicated myocarditis. MaJor abnormal findings of fatal cases were as follows; completeatrioventricular block in 7 cases, atrioventricular nodal rhythm in 4 cases, idioventricular rhythm in 3 cases. Possible ccises of fal cases in related to disturbance of conduction and impulse formation were also observed.
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