The heart in enteric (typhoid) fever

The status of cardiac involvement in cases of typhoid is variable and conflicting reports are available in literature. Cardiac involvement as assessed by electrocardiograms was present in 35 cases out of 294 cases of enteric (11.9%). These ranged from minor alterations to prolongation of P--R interval, Q--Tc interval and T wave changes as well as myocarditis. Rhythm disturbances were present in 12 cases. Electrocardiographic alterations bore a direct relationship to the severity of disease process, occurred at the height of illness and had a bearing on the prognosis. There was no relationship between electrolyte and enzyme alterations and ECG changes. Prognosis was poor in patients where the electrocardiographic alterations persisted and such cases usually proved fatal.