| Clinical Studies on Diphtheritic Myocarditis |
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Suk Chui Kang, Soon Yong Lee, Yong Kyoo Lee, Chang Yee Hong |
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Department of Pediatrics, Seoul National University |
| 디프테리아 心筋炎의 臨床的 觀察 |
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姜碩哲, 李純鎔, 李庸圭, 洪影義 |
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서울大學校 醫科大學 小兒科學敎室 |
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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 (8.8%) of 618 cases developed clinical and lectrocardiographic 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 ahdominal 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 myocarditis 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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