[Clinicofunctional changes of heart in patients with clinically different variants of toxic diphtheria].

A clinicofunctional examination of 72 patients with toxic diphtheria (mean age 36.8 +/- 7.1 years) has been made to study the course and outcome of diphtheria-related damage to the heart. It is shown that clinical symptoms of myocarditis became more prominent with growing severity of diphtheric infection and evidenced for diffuse affection of the left ventricle. EchoCG detected defective systolic function which in patients with unfavorable prognosis was associated with thickening of the myocardium and dilatation of the left ventricular chamber. 24-h Holter monitoring registered shifts in the end part of the ECG ventricular complex and various abnomalities in the heart rhythm. Focal myocardial lesions manifested with supraventricular and solitary ventricular extrasystoles. In diffuse myocarditis frequent ventricular extrasystoles prevailed. At autopsy, structural myocardial changes in toxic diphtheria were confirmed.