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조명찬,주인종,김대중,이병직,정형배,이명묵,박영배,최윤식,서정돈,이영우 대한내과학회 1990 대한내과학회지 Vol.38 No.3
We reviewed 549 electrocardiograms obtained from 95 patients with Korean hemorrhagic fever to investigate the incidence and electrocardiographic characteristics, observe evolutional changes in those findings during the course of illness, identify the correlations with clinical findings, and then suggest pathophysiologic mechanisms in the development of abnormal electrocardiographic findings. The overall incidence of electrocardiographic abnormalites was 95.7%, and the frequency of each phase was 87.8% in the febrile phase, 91.3% in the hypotensive phase, 86.5% in the oliguric phase, 76.4% in the diuretic phase and 43.0% in the convalescent phase. The cardinal electrocardiographic findings were QT prolongation(82.1%), sinus bradycardia(73.7%), prominent U wave(53.7%), tall and peaked T wave(51.6%), ST-T changes(41.1 %) and sinus tachycardia(35.8%). The most frequently observed electrocardiographic findings of each phase were sinus tachycardia in the febrile and hypotensive phase, QT prolongation in the oliguric phase, sinus bradycardia in the diuretic phase and prominent U wave in the convalescent phase. The occurrence of abnormal electrocardiograms increased in patients with high serum creatinine levels during the oliguric and diuretic phases. The electrocardiographic abnormalities that persisted to the convalescent phase were QT prologation(seven cases), prominent U wave(seven cases), sinus bradycardia(five cases), and tall and peaked T wave(four cases). Even though almost all of the electrocardiographic abnormalities were mild and recovered shortly after the convalescent phase and there were no diagnostic electrocardiograms, we observed noteworthy electrocardiographic characteristics and evolutional changes during the course of illness and suggested the primary electrocardiographic changes in Korean hemorrhagic fever.
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