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Echocardiographic follow-up of diphtheric myocarditis
K W Groundstroem1, G Molnar, J Lumio
1Department of Medicine, Tampere University Hospital, Finland.
Insights
This study documents diphtheric myocarditis using serial electrocardiography and echocardiography. Electrocardiographic changes appeared 3 weeks before contraction abnormalities, highlighting subtle cardiac involvement in diphtheria.
Area of Science:
- Cardiology
- Infectious Diseases
- Clinical Medicine
Background:
- Diphtheria, caused by Corynebacterium diphtheriae, can lead to severe systemic complications.
- Myocarditis is a known but often underdiagnosed complication of diphtheria.
- Early detection of diphtheric myocarditis is crucial for patient outcomes.
Observation:
- This case presents the first documentation of diphtheric myocarditis using serial electrocardiography (ECG) and echocardiography.
- The patient experienced a prolonged neurologic disease with extensive polyneuropathy.
- Clinical signs of myocarditis were subtle despite significant cardiac involvement.
Findings:
- Electrocardiographic changes were observed to precede echocardiographic findings of contraction abnormalities by three weeks.
- Serial ECG monitoring revealed cardiac involvement earlier than clinical presentation.
- Diagnostic imaging confirmed myocardial dysfunction secondary to diphtheria.
Implications:
- Serial electrocardiography is a valuable tool for detecting early cardiac involvement in diphtheria patients.
- Repetitive echocardiographic examinations are warranted in diphtheria cases with ECG abnormalities.
- This case underscores the importance of comprehensive cardiac assessment in infectious diseases with potential systemic effects.
Abstract:
We report the first case of diphtheric myocarditis documented by serial electrocardiography and echocardiography. The electrocardiographic changes preceded the contraction abnormalities by 3 weeks. During a prolonged neurologic disease with extensive polyneuropathy, the patient had only subtle clinical signs of myocarditis. In patients with diphtheria, electrocardiographic changes may warrant repetitive echocardiographic examinations.