Electrocardiographic abnormalities in generalized tetanus

Longo, Michael; Mark, Herbert

doi:10.1016/s0022-0736(71)80040-7

Cited by 1 publication

(3 citation statements)

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“…Arrhythmias are observed in tetanus patients, especially in the more severe forms, hypercatecholaminemia being the highest risk factor 1,3,7,8,10,15,27 . This study detected a low frequency of arrhythmias of clinical relevance and, unlike what was expected, there was no difference when we compared the presence of arrhythmia in general either between Groups A and B or between patients with and without sympathetic overactivity detected by 24 hours electrocardiographic (Holter) monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…The cardiovascular manifestations of tetanus consist of disturbances of heart rate and rhythm, blood pressure instability, arrhythmias, myocardial dysfunction and sympathetic overactivity 10,15,20,30 . They may be due to the direct action of the tetanus toxin on the heart, to the drugs used to control rigidity and spasms, and to the hypersympathetic state induced by the failure to inhibit adrenal release of catecholamines 7,8,23,29 .…”

Section: Introductionmentioning

confidence: 99%

“…Current literature on the topic is scanty and states that patients who develop more severe clinical conditions more frequently present hemodynamic, myocardial or electrocardiographic abnormalities than those with the milder forms of tetanus 3,4,10,28,30 .…”

Section: Introductionmentioning

confidence: 99%

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Sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysis

Filho

Lacerda²,

Albuquerque

et al. 2007

Rev. Inst. Med. trop. S. Paulo

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As a result of the advances in the control of pulmonary insufficiency in tetanus, the cardiovascular system has increasingly been shown to be a determining factor in morbidity and mortality but detailed knowledge of the cardiovascular complications in tetanus is scanty. The 24h-Holter was carried out in order to detect arrhythmias and sympathetic overactivity in 38 tetanus patients admitted to an ICU. The SDNN Index (standard deviation from the normal R-to-R intervals), was useful in detecting adrenergic tonus, and ranged from 64.1 +/- 27 in the more severe forms of tetanus to 125 +/- 69 in the milder ones. Sympathetic overactivity occurred in 86.2% of the more severe forms of the disease, but was also detected in 33% of the milder forms. Half the patients had their sympathetic overactivity detected only by the Holter. The most frequent arrhythmias were isolated supraventricular (55.2%) and ventricular (39.4%) extrasystoles. There was no association of the arrhythmias with the clinical form of tetanus or with the presence of sympathetic overactivity. The present study demonstrated that major cardiovascular dysfunction, particularly sympathetic overactivity, occurs in all forms of tetanus, even in the milder ones. This has not been effectively detected with traditional monitoring in ICU and may not be properly treated.

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