Electrocardiographic Alterations in Rheumatic Fever in Children

In patients with rheumatic fever the heart frequently is involved, and if manifestations in the joints are slight or absent the diagnosis of rheumatic fever may depend on the demonstration of the presence of cardiac involvement by physical examination or by laboratory methods, especially by the electrocardiographic examination. Considerable difference of opinion exists with regard to the frequency of abnormalities and of alterations in individual waves in the electrocardiogram of patients with rheumatic fever. In table 1 are assembled the electrocardiographic changes described in some of the larger series of 'reported cases.¹The discordant results probably can be attributed to the stage of the diseaseat which the tracing was taken, the frequency or absence of serial records and the variations in standard criteria for the determination of abnormality in a single electrocardiogram. The electrocardiogram is more likely to be abnormal during the acute stage of the disease or