Five hundred and sixty seven electrocardigrams recorded or five hundred sixteen cases of typhoid fever were analyzed and the data obtained were compared by duration of the illness, age groups, hemoglobin levels and complications. In addition, a follow-up observation was made, in a umber of cases with abnormal electrocardiograms on admission.
The tracings were abnormal in three hundred and fifty cases out of five hundred and sixteen, the incidence being 67.8 percent. Among various findings, cardinal abnormalities were prolongation of Q-T interval, ST-T changes and prolongation in of P-R interval: the overall incidences of these being 24.4%, 20.2% and 10.3%, respectively. These findings, were more common in those with various complications or severe anemia as expected, but, they had disappeared within 10 days in about 30 to 60% of the cases whose follow-up electrocardiograms were available. Among mechanism disorders, excluding sinus tachycardia and sinus bradycardia, atrial fibrillation was seen in 0.4% of the cases, the second degree heart block in 0.8%, both atrial. and ventricular prematures in 0.6% respectively. The prolongation of Q-T interval was more common in the older age group and in those cases with duration of the. illness of three weeks or more, whereas the prolongation of P-R irate vat as noted more frequently in the younger age group and in patients who. had been ill for more than 6 weeks. The age of two cases with the second degree heart block out of four was below twenty. Obviously multiple factors are responsible for the electrocardiographic changes in typhoid fever but it was felt that at least in some of the cases these findings mentioned are most probably caused by myocardial damage or myocarditis.
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