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January 1948

COMPLETE ATRIOVENTRICULAR BLOCK IN DIPHTHERITIC MYOCARDITIS: Report of a Case with Serial Electrocardiographic Tracings

Author Affiliations

Chief of Cardiovascular Section, Medical Corps, Army of the United States; Senior Resident in Internal Medicine, Medical Corps, United States Army

From the Medical Service, Madigan General Hospital, Tacoma, Washington, Colonel Maxwell G. Keeler commanding and Colonel Albert H. Robinson chief of Medical Service.

Arch Intern Med (Chic). 1948;81(1):9-18. doi:10.1001/archinte.1948.00220190017002

REVIEW OF THE ENGLISH LITERATURE, 1901 TO 1946  UNTIL recently, partial atrioventricular block in diphtheria has been recognized rarely and detailed serial studies of complete atrioventricular block in diphtheria have been scarce. It was difficult to ascertain from the literature the first reported cases of heart block of any degree, because undoubtedly some occurred which were unrecognized for want of technologic apparatus. White and Smith reviewed 946 cases of diphtheria in 1904 studied at the Boston City Hospital, and in 3 of these pulse rates "to 30 or even 20" were present; these undoubtedly were cases of complete heart block, but electrocardiographic technics were not available to the authors.

First and Second Degree Atrioventricular Block.  —As Stecher noted, at least 2 instances of partial heart block in diphtheria have been reported before 1938, 1 by Hume in 1913 and 1 by Hecht, cited by Marvin, in 1924. Since 1938, Burkhardt

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