Abstract
Ventrikül içinde uyarı iletimindeki gecikmenin sağ daldan, sol ana dal ile sol ön ve arka fasiküllerin ikisine yerleştiği durumlara bifasiküler blok adı verilmektedir. Konjenital veya edinsel kalp hastalıklarına bağlı olarak ortaya çıkabilmektedir. Dört yaşındaki kız hasta, genel anestezi altında diş çekimine hazırlık amacıyla çekilen elektrokardiyografisinde (EKG) superior QRS aksı ile birlikte sağ dal bloğu ve sol anterior hemiblok saptanması üzerine çekilen ekokardiyografisinde interventriküler geçişin ortak AV kapağın bridging lifletleri tarafından engellendiği komplet atriyoventriküler septal defekt saptandı. Yapılan anjiyografisinde primum ASD’den minimal geçiş izlenen hasta hemodinamik stabil olması nedeniyle klinik izlem kararı alındı. Sonuç olarak, dikkatli EKG incelemesi ile asemptomatik seyreden primum ASD’li hastaların pulmoner vasküler hastalık gelişmeden tanı alması sağlanabilir.
References
- Park MK, Guntheroth WG. How to Read Pediatric ECGs. 4 th ed. Philadelphia: Mosby, 2006: 94
- Park MK. Pediatric Cardiology for Practitioners. 5 th ed. Philadelphia: Mosby, 2008:181-7
- Singh RR, Warren PS, Reece TB, Ellman P, Peeler BB, Kron Il. Early repair of complete atrioventricular septal defect is safe and effective. Ann Thorac Surg 2006; 82:1598-601.
- Ho SY, Russell G, Gerlis lM. Atrioventricular septal defect with intact septal structures in a 74-year-old. Int J Cardiol 1990; 26: 371–3.
- Silverman nH, Ho SY, Anderson RH, Smith A, Wilkinson Jl. Atrioventricular septal defect with intact atrial and ventricular septal structures. Int J Cardiol 1984; 5: 567–73.
- Piccoli GP, Gerlis lM, Wilkinson Jl, lozsadi K, Macartney FJ, Anderson RH. Morphology and classification of atrioventricular defects. Br Heart J 1979; 42: 621–32.
- Thiene G, Wenink AC, Frescura C, Wilkinson Jl, Gallucci V, Ho SY, et al. Surgical anatomy and pathology of the conduction tissues in atrioventricular defects. J Thorac Cardiovasc Surg 1981; 82: 928–37.
- Fournier A, Young M, Garcia Ol, Tamer DF, Wolff GS. Electrophysiologic cardiac function before and after surgery in children with atrioventricular canal. Am J Cardiol 1986; 57: 1137–41.
by Determination of the Bifascicular Block An Asymptomatic Patient with Atrioventricular Septal Defect Diagnosed
Abstract
Bifascicular block is defined as left bundle branch block or right bundle branch block associated either with a left anterior or left posterior fascicular block. It can be due to congenital or acquired heart disease. Electrocardiography for preparation before dental extraction therapy under general anesthesia in a 4-year-old girl showed superior QRS axis, right bundle branch block and left anterior hemiblock. Echocardiographic examination revealed complete atrioventricular septal defect that prevented interventricular transition by bridging leaflets. Angiography showed minimal left to right shunt via the primum ASD. Clinical follow-up was decided on as the patient was hemodynamically stable. Primum atrial septal defect can be diagnosed before the development of pulmonary vascular disease by careful assessment of the ECG in asymptomatic patients
References
- Park MK, Guntheroth WG. How to Read Pediatric ECGs. 4 th ed. Philadelphia: Mosby, 2006: 94
- Park MK. Pediatric Cardiology for Practitioners. 5 th ed. Philadelphia: Mosby, 2008:181-7
- Singh RR, Warren PS, Reece TB, Ellman P, Peeler BB, Kron Il. Early repair of complete atrioventricular septal defect is safe and effective. Ann Thorac Surg 2006; 82:1598-601.
- Ho SY, Russell G, Gerlis lM. Atrioventricular septal defect with intact septal structures in a 74-year-old. Int J Cardiol 1990; 26: 371–3.
- Silverman nH, Ho SY, Anderson RH, Smith A, Wilkinson Jl. Atrioventricular septal defect with intact atrial and ventricular septal structures. Int J Cardiol 1984; 5: 567–73.
- Piccoli GP, Gerlis lM, Wilkinson Jl, lozsadi K, Macartney FJ, Anderson RH. Morphology and classification of atrioventricular defects. Br Heart J 1979; 42: 621–32.
- Thiene G, Wenink AC, Frescura C, Wilkinson Jl, Gallucci V, Ho SY, et al. Surgical anatomy and pathology of the conduction tissues in atrioventricular defects. J Thorac Cardiovasc Surg 1981; 82: 928–37.
- Fournier A, Young M, Garcia Ol, Tamer DF, Wolff GS. Electrophysiologic cardiac function before and after surgery in children with atrioventricular canal. Am J Cardiol 1986; 57: 1137–41.
Details
| Other ID | JA44BT56CT |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | December 1, 2013 |
| Submission Date | December 1, 2013 |
| Published in Issue | Year 2013 Volume: 7 Issue: 4 |
The publication language of Turkish Journal of Pediatric Disease is English.
Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 7 articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.
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