Sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysis
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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Instituto de Medicina Tropical de São Paulo
2007
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oai:scielo:S0036-466520070001000042007-03-19Sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysisHenriques Filho,Gustavo TrindadeLacerda,Heloisa RamosAlbuquerque,AfonsoXimenes,Ricardo Arraes de Alencar Tetanus Cardiovascular system Arrhythmias Sympathetic overactivity 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.info:eu-repo/semantics/openAccessInstituto de Medicina Tropical de São PauloRevista do Instituto de Medicina Tropical de São Paulo v.49 n.1 20072007-02-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652007000100004en10.1590/S0036-46652007000100004 |
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Henriques Filho,Gustavo Trindade Lacerda,Heloisa Ramos Albuquerque,Afonso Ximenes,Ricardo Arraes de Alencar |
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Henriques Filho,Gustavo Trindade Lacerda,Heloisa Ramos Albuquerque,Afonso Ximenes,Ricardo Arraes de Alencar Sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysis |
author_facet |
Henriques Filho,Gustavo Trindade Lacerda,Heloisa Ramos Albuquerque,Afonso Ximenes,Ricardo Arraes de Alencar |
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Henriques Filho,Gustavo Trindade |
title |
Sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysis |
title_short |
Sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysis |
title_full |
Sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysis |
title_fullStr |
Sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysis |
title_full_unstemmed |
Sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysis |
title_sort |
sympathetic overactivity and arrhythmias in tetanus: electrocardiographic analysis |
description |
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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Instituto de Medicina Tropical de São Paulo |
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2007 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652007000100004 |
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