Cardiovascular collapse in acute poliomyelitis.

ALTHOUGH cardiovascular collapse had previously been noted in patients with acute poliomyelitis,' 2 Baker and his colleagues3' 4first indicated that this lethal symptom complex is a relatively common feature of bulbar poliomyelitis. They examined in detail the medulla of 80 cases dying of poliomyelitis and concluded that this syndrome was due to involvement of the large cells in the ventromedial reticular substance of the medulla. There are also reports in the literature noting the occurrence of an interstitial myocarditis in poliomyelitis.'-10 Electrocardiographic changes in a variable proportion of patients with acute poliomyelitis have also been reported.6 9 These reports do not record whether the histologic changes described by Baker and his associates4 occurred in their cases. On the other hand, the reports by Baker and his colleagues3' 4deal mainly with the central nervous system findings. Maloney and Whittenbergerll suggested from their experiments on dogs that a high negative intratank pressure may play an important role in cardiovascular collapse in respirator patients by interfering with the return of blood to the heart, particularly if the circulation is failing. In view of the uncertain role played by different factors in the etiology of this syndrome,