Electrocardiographic studies in cretins.

There is no direct method of estimating accurately the function of the thyroid gland; so other measures have to be employed in diagnosing thyroid deficiency and in regulating subsequent treatment. Recognition of typical cases of hypothyroidism should not be difficult, but there are borderline cases with slight symptoms that are not so easy to detect. Standard methods of investigation are helpful but have their limitations particularly in young children. At this early age, for instance, accurate estimation of the basal metabolic rate is difficult and therefore unreliable. The blood cholestrol level is usually raised in hypothyroidism, but the test may fail in early or mild forms of the disorder and other conditions may be associated with a high figure. In searching for additional means of diagnosis attention has been drawn to certain electrocardiographic changes pointing to a disturbed action of the heart. This method of investigation has been used only to a very limited extent in children and paediatric textbooks contain little or no information on the subject.