Göğüs ağrısı ile başvuran çocuk ve ergenlerin klinik özellikleri

Year 2024, Volume: 14 Issue: 1, 15 - 20, 31.01.2024

Gülden Ünver , Ahmet Sert

https://doi.org/10.16899/jcm.1295809

Cited By: 1

Abstract

Özet


Öz: Göğüs ağrısı çocuklarda sık görülen bir hastalıktır. Göğüs ağrısı, pediatrik kardiyologlar tarafından kardiyak üfürümlerden sonra en sık belirtilen ikinci semptomdur.

Amaç: Bu prospektif çalışmada, çocuk kardiyoloji polikliniğimize başvuran çocuklarda göğüs ağrısının klinik özelliklerini ve nedenlerini değerlendirmeyi amaçladık.

Metod: Bu prospektif çalışmayı 1 Haziran 2017 - 1 Haziran 2020 tarihleri arasında üçüncü basamak bir hastanede göğüs ağrısı olan 446 hasta arasında gerçekleştirdik. Hastaların demografik verileri ve klinik özellikleri analiz edildi. Tüm hastalar anamnez, fizik muayene, laboratuvar testleri, elektrokardiyogram ve ekokardiyogram ile değerlendirildi ve gerekirse telekardiyogram, 24 saatlik elektrokardiyogram monitorizasyonu, egzersiz stres testi ve psikolojik değerlendirme yapıldı.

Bulgular: Akut ağrı ile başvuru oranı %4 iken hastaların %20'sinde kronik göğüs ağrısı vardı. Göğüs ağrısı ile ilişkili en yaygın semptomlar nefes darlığı ve çarpıntı idi. Kalp dışı nedenler sırasıyla %25 kas-iskelet, %14 psikolojik, %9 solunum ve %7 gastrointestinal idi. Hastaların 49'unda (%11) kardiyak göğüs ağrısı bulduk. 153 (%34) hastada idiyopatik göğüs ağrısı saptandı.

Sonuç: Çalışmamız göğüs ağrısı ile başvuran çocuk ve ergenlerde göğüs ağrısı etiyolojisinin daha çok kalp dışı nedenlere bağlı olduğunu göstermiştir. Literatüre kıyasla pediatrik göğüs ağrısının kardiyak etiyolojileri için biraz yüksek oran sıklığı bulduk. Göğüs ağrısı etiyolojisinin belirlenmesinde anamnez ve dikkatli muayeneye ek olarak gerekirse ileri tetkiklerin önemli olduğunu düşünüyoruz.

Anahtar Kelimeler: Adölesan; etiyoloji; çocuk; göğüs ağrısı; ekokardiyogram

Keywords

adölesan, etiyoloji, çocuk, göğüs ağrısı, ekokardiyogram

Clinical characteristics of children and adolescents admitted with chest pain

Abstract

Abstract

Background: Chest pain is a common disease in children. Chest pain is the second most common symptom referred to by paediatric cardiologists after cardiac murmurs.
Objective: In this prospective study, we aimed to evaluate clinical characteristics and causes of chest pain in children admitted to our paediatric cardiology outpatient clinics.
Methods: We conducted this prospective study among 446 patients with chest pain in a tertiary care hospital from 1 June 2017 to 1 June 2020. The demographic data and clinical characteristics of the patients were analysed. All patients were evaluated with a medical history, physical examination, laboratory tests, electrocardiogram and echocardiogram and if necessary telecardiogram, 24-hour electrocardiogram monitoring, exercise stress test and psychological evaluation were made.
Results: The ratio of admissions with acute pain was 4% when 20% of the patients had chronic chest pain. The most common symptoms associated with chest pain were shortness of breath and palpitations. The non-cardiac causes were as follows: 25% musculoskeletal, 14% psychological, 9% respiratory, and 7% gastrointestinal, respectively. We found cardiac chest pain in 49 (11%) of patients. Idiopathic chest pain was found in 153 (34%) patients.
Conclusions: Our study showed that the aetiology of chest pain in children and adolescents admitted with chest pain is mostly due to non-cardiac causes. We found the slightly frequency of elevated rate for cardiac aetiologies of paediatric chest pain compared to the literature. We suggest that in addition to anamnesis and careful examination, further investigation, if necessary, is important in determining the aetiology of chest pain.

Keywords

adolescent, aetiology, child, chest pain, echocardiogram

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