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- W2068244384 abstract "Twenty-one patients with clinically severe second degree S-A block were studied. Six patients had had severe diphtheria 17 to 48 years before. Rheumatic heart disease, transitory vagotonia, electrolyte disturbances, and drugs were not found to be of main etiological importance. Organic damage of the sinus node and adjacent tissues, sometimes caused by diphtheric myocarditis, is the most probable underlying cause.The S-A block was permanent in most cases and its predominant manifestation was fluctuations of rhythm. On one hand, 10 patients had periods in which no sinus activity could be demonstrated, which may be interpreted as development from second to third degree S-A block. On the other hand, 14 patients had attacks of supraventricular tachycardias, probably representing escape tachycardias caused by sinus impulse failure. The changes in rhythm constituted the dominant therapeutic problem.The prognosis in S-A block is better than in A-V block, but 15 of the patients had malignant syncopes, and 2 patients had subsequent cerebral damage. The treatment of choice is insertion of a pacemaker, which prevents the bradycardia and, therefore, also the tachycardia and permits adequate use of digitalis preparations. Seventeen patients had pacemakers implanted, most of them of the QRS-triggered type." @default.
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- W2068244384 date "1937-05-01" @default.
- W2068244384 modified "2023-09-26" @default.
- W2068244384 title "The heart fifteen to twenty years after severe diphtheria" @default.
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- W2068244384 doi "https://doi.org/10.1016/s0002-8703(37)90892-5" @default.
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