Journal of the Korean Pediatric Society 1974;17(1):41-51.
Published online January 31, 1974.
Electrocardiographic Abnormalities in Diphtheric Children
Byung Joo Chung, Dong Min Lee, Dong Sup Han
Department of Pediatrics,School of Medicine, Kyungpook National^ University Taegu, Korea
小兒 디프테리아의 異常心電圖에 對하여
鄭兼周, 李東敏, 韓東變
慶北大學校 醫科大學 小兒科學敎室
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. I960 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 in 36.5 percent. In the abnormalities at the first E.C.G., the changes of ST segment and T wave was most often (9.3%), next the prolongation of Q-T interval (8.1%), and the prolongation of P.R. interved in the rate of 3.4 per cent. The various findings of 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 in eluded 9.9 per cent (10 o£ 101) in the prolongation of Q-T interval, 7.9 per cent 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 electrocarpiographic 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 and 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, respectively, 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; complete atrioventricular block in 7 cases, atrioventricular nodal rhythm in 4 cases, idioventricular rhythm in 3 castes. Possible causes of fal cases in related to disturbance of conduction and impulse formation were also observed.

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