Wolff- Parkinson-White Elektrokardiyografik Paterni Saptanan Çocuklarda Klinik Değerlendirme ve Semptomatik Olguların Sunumu

Year 2011, Volume: 5 Issue: 4, 220 - 230, 01.04.2011

Filiz Ekici İbrahim İlker Çetin Leyla Bilgin Karadeniz

Abstract

Amaç: Wolff –Parkinson- White (WPW) elektrokardiyografik paterni saptanan çocuk hastaların demografik özellikleri, başvuru yakınmaları, elektrokardiyografik ve ekokardiyografik özellikleri ve tedavi yöntemleri değerlendirilmiştir. Materyal ve Yöntem: Bu çalışma tek bir merkezde ve üçüncü basamak araştırma hastanesinde 2009-2011 yılları arasında retrospektif olarak yapılmıştır. Yüzeyel EKG’ de WPW paterni saptanan 21 çocuk olgu (1 gün-15 yaş) çalışmaya dahil edildi. Hastalar asemptomatik veya Semptomatik olmak üzere iki gruba ayrıldı. Bulgular: Olguların çoğu (13 olgu, ortalama yaş: 6.0 yıl) tanı anında ve çalışma süresince asemptomatikti. Disritmi ile ilişkili semptomlar 8 olguda (ortalama yaş: 9.1 yıl) belirlendi. Gruplar arasında cinsiyet bakımından fark saptanmadı. Başvuru semptomları: dört olguda çarpıntı ve bir olguda senkop idi. Üç olgu Supraventriküler taşikardi atağı ile başvurdu ve SVT’li olguların tümünde intermittent tipte WPW paterni ve erkek cinsiyet predominansı saptandı. Ekokardiyografi ile yedi olguda mitral kapak prolapsusu, üç olguda hipertrofik kardiyomiyopati, bir olguda aort yetersizliği ve bir olguda Ebstein anomalisi saptandı. SVT ataklarında Amiodoron veya Adenozin ile başarılı tedavi sağlandı. Çalışma süresince olguların hiçbirisinde ani ölüm gözlenmedi. Sonuç: WPW elektrokardiyografik paterni tanısı alan çocuklara uygun tedavi uygulanmalıdır.

Keywords

Wolff-Parkinson-White, çocuk, elektrokardiyografi, ekokardiyografi

CLINICAL EVALUATION OF CHILDREN WITH ELECTROCARDIOGRAPHIC PATTERN OF WOLFF-PARKINSON-WHITE AND PRESENTING OF SYMPTOMATIC CASES

Abstract

Aims: To evaluate the children with electrocardiographic pattern of Wolff-Parkinson-White (WPW) and review their demographic features, presenting symptoms, electrocardiographic, echocardiographic findings, and management. Methods: The study was conducted in a single tertiary research hospital from 2009 to 2011, retrospectively. Twentyone children (1 day to 15 years) with a WPW pattern on surface ECG were included in this study. We classified patients into two groups as “Asymptomatic” and “Symptomatic Group”. Results: Most children were asymptomatic (13 cases, mean age: 6.0 years) at the diagnosis and during the study period. Symptoms related to dysrhtyhmia were recognized in 8 cases (mean age: 9.1 years) and most common in school age children. There were no gender predominance between two groups. The symptoms were palpitations in 4 cases and syncope in one case. Three cases presented with attack of supraventricular tachycardia (SVT). They also had intermittent nature of WPW and male predominance. Echocardiography revealed mitral valve prolapsus in 7, hypertrophic cardiomyopathy in 3, aortic regurgitation in 1 and Ebstein abnormality in 1 case. SVT were successfully treated with Amiodoron or Adenosine. No patient died suddenly during the study period.Conclusion: Children with electrocardiographic pattern of WPW should be recognized and managed properly

Keywords

Wolff-Parkinson-White, children, electrocardiography, echocardiography

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