[Clinical and instrumental diagnosis of cardiac affection in patients with toxic diphtheria].
OBJECTIVE
To specify myocardial affection in adult patients with toxic diphtheria (TD).


METHODS
Along with routine clinical examination 150 patients with toxic diphtheria underwent ECG, echo-CG and biochemical tests. 22, 81, 26, 14 and 7 patients had subtoxic TD, toxic form of the first degree, second degree, third degree and hemorrhagic TD, respectively.


RESULTS
Myocardial impairment in TD develops very early, but is diagnosed in different time depending on the diagnostic technique. Early signs of myocardial involvement are activation of cardiospecific enzymes and echo-CG changes. Poor myocardial prognosis in TD is predetermined by progressive cardiac failure (primarily right ventricular), marked conduction disorders, diminished contractility, hyper- or hypoactivity of cardiospecific enzymes.


CONCLUSIONS
The knowledge of myocardial affection variants in TD enables the clinician not only to predict the disease course but to conduct more adequate therapy resultant in less numerous lethal outcomes of toxic TD.
Iushchuk
N D
ND
Filippov
P G
PG
Filippov
M G
MG
Roslyĭ
I M
IM
Maev
S V
SV
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D003937:Diagnosis, Differential; D003935:Diagnostic Techniques, Cardiovascular / Q000295:instrumentation*; D004165:Diphtheria / Q000150:complications*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis* / Q000201:enzymology / Q000209:etiology; D006801:Humans; D006884:Hydroxybutyrate Dehydrogenase / Q000097:blood; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D012189:Retrospective Studies
D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase; D006884:Hydroxybutyrate Dehydrogenase; D001219:Aspartate Aminotransferases; D003402:Creatine Kinase