Digitalis Studies on Children With Heart Disease

Abstract

The purpose of this study was to determine the effects of digitalis on the electrocardiograms of children with rheumatic heart disease and signs of heart failure. It has been shown by Cohn and his co-workers 1 that an alteration in the size, shape and direction of the T wave of the electrocardiogram is the earliest index of digitalis action. This may take place before disturbances in rhythm and conduction time have occurred and before the patient exhibits any minor toxic manifestations, such as nausea and vomiting. The changes in the electrocardiogram consist essentially in a progressive diminution of the size of the T wave in either one or all three leads, with final inversion of previously upright waves. In cases yielding downwardly directed T waves before the use of digitalis, the drug produces eventually upwardly directed waves. These variations have found ample support in subsequent clinical and experimental observations on both man and animals.2 In children, however, a similar systematic study of the effects of digi¬ talis on the electrocardiogram has not been carried out with any degree of accuracy. Since the optimal dosage of digitalis and its value and limitations in children with heart disease are still mooted questions,3