Abstract
Twenty-one patients with lobar pneumonia, and 5 patients with broncho pneumonia were electrocardiographed daily to learn whether there was any graphic evidence of myocardial involvement during the disease. For the most part the patients were young adult males. No patient had received digitalis before admission or during his stay in the hospital. It is important to rule out this drug for it produces changes in the electrocardiogram.
Cohn and Jamieson 1 took one or 2 and occasionally more electrocardiograms in each of 56 patients who had received no digitalis. They used these patients as controls in their study of the action of digitalis in pneumonia. It is essential, however, to take daily records as some of the changes in the electrocardiogram are transient and disappear in a day or two. Cohn and Jamieson noted 2 cases with P-R and T changes, and 8 cases with T changes alone. What criteria were used for T-wave changes is not made clear, but we have only considered inversions or flattening of the T-wave, not mere change in size of a normal T-wave.
Early in pneumonia, and in very severely ill patients, T-wave inversions may appear; during the height of the illness or in beginning convalescence R-T deviations may be present; but during convalescence increased auriculoventricular conduction disturbances occur.
The T-wave inversions occurred in 4 individuals; 2 of the patients showed changes in leads II and III, the other 2 in leads I, II and III. The latter 2 patients died, one had a lobar and the other a broncho-pneumonia. In all 4 cases, the T-wave inversions disappeared in 24-48 hours. Flattening of the T -wave in lead I or II occurred 3 times and appeared of more significance when present in lead I.
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