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[Clinical and structural parallels in changes of the myocardial conduction system in diphtheria patients]
Insights
Clinical device investigations of the heart in diphtheria correlate with autopsy findings. Diphtheria affects the myocardium more than the cardiac conduction system, with inflammation leading to myocardiosclerosis.
Area of Science:
- Cardiology
- Pathology
- Infectious Diseases
Background:
- Diphtheria can cause significant cardiac complications.
- Understanding the cardiac manifestations of diphtheria is crucial for patient management.
Purpose of the Study:
- To compare clinical heart investigations with morphological autopsy findings in diphtheria patients.
- To elucidate the structural-functional changes in the heart during diphtheria.
Main Methods:
- Investigated hearts from 309 diphtheria patients (aged 25-80) and 60 controls.
- Utilized ECG, echo-CG, Doppler echo-CG, Holter monitoring, and biochemical blood tests.
- Performed structural analysis of the cardiac conduction system (sinus-atrial node, atrioventricular node, bundle) and adjacent myocardium.
Main Results:
- Pathological processes in diphtheria lead to varied structural-functional states of the myocardium and conduction system.
- Early diphtheria (days 1-10) showed dystrophic, necrobiotic, and vascular disorders, followed by inflammation and myocardiosclerosis (days 11-30).
- The cardiac conduction system nodes and bundles were affected less frequently than the myocardium.
Conclusions:
- A correlation exists between the structural status of the cardiac conduction system and clinical heart conditions in diphtheria.
- Individual variations in conduction system structure influence diphtheria's cardiac impact.
Aim:
Comparison of the results of clinical device investigations of the heart with morphological autopsy evidence in diphtheria.
Material And Methods:
Hearts of 309 patients with diphtheria aged 25 to 80 years and 60 hearts of patients who died of diphtheria were investigated using ECG, echo-CG, doppler echo-CG, Holter ECG monitoring, biochemical tests of blood. Structural study of cardiac conduction included examination of the sinus-atrial node, atrioventricular node and bundle regarding the adjacent myocardium.
Results:
Variants of structural-functional state of the myocardium and conduction system are explained by variability of the pathological processes which arose due to individual features of the conduction system structure and location, relationships with the myocardium. In acute diphtheria (day 1-10) dystrophic, necrobiotic and vascular disorders prevailed followed on days 11-30 by inflammation ending in myocardiosclerosis. Nodes and bundles of the conduction system are affected less frequently than the myocardium.
Conclusion:
A correlation exists between structural state of the cardiac conduction system and variants of clinical affection of the heart in diphtheria.