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Electrocardiographic findings and QT dispersion in children with chest pain Original Article

Year 2009, Volume: 44 Issue: 2, 53 - 56, 01.06.2009

Abstract

Aim: Chest pain is common in childhood and the reason can not be found in most cases Its known relation with coronary artery disease in adult patients causes anxiety in patients and parents QT dispersion is studied in this group of patients and risk of sudden death and life threatening arrhythmia is investigated Material and Method: The study group consisted of 10 girls and 13 boys aged between 5 and 15 years and the control group consisted of 21 boys and 7 girls aged between 5 5 and 15 years Heart rate RR interval RR variability PR interval time and amplitude of P wave P wave axis QRS distance QRS axis QT interval corrected QT QTc QT dispersion and QTc dispersion obtained from the surface electrocardiograms were compared Results: A significant difference was not found between the groups regarding heart rate RR interval RR variability PR interval P wave and QRS axis QRS interval and QT interval P wave amplitude was higher in the patients with chest pain than the control group 1 6±0 6 and 1 3±0 04 respectively p lt;0 03 QT dispersion in the patients and the controls were 65±23 msn and 61±17 msn QTc dispersion in the patients and in the controls were 106±2 msn and 113±23 msn QT dispersion values using 12 derivation electrocardiograms precordial derivations and extremity derivations were correlated to each other r=0 47 p lt;0 005 and r=0 24 p lt;0 02 Conclusions: Children with idiopathic chest pain do not have an increased risk for life threatening arrhythmia or sudden death Increased P wave amplitude suggests the need of evaluation for pulmonary dysfunction Turk Arch Ped 2009; 44: 53 6 Key words: Arrhythmia chest pain electrocardiography QT dispersion

References

  • Selbst SM. Evaluation of chest pain in children. Pediatr Rev 1986; 6: 56-62.
  • Kocis KC. Chest pain in pediatrics. Pediatr Clin North Am 1999; 46: 189-203.
  • Brenner JI, Ringel RE, Berman MA. Cardiologic perspectives of chest pain in childhood: A referral problem? To whom? Pediatr Clin North Am 1984; 31: 1241-58.
  • Selbst SM. Chest pain in children. Pediatrics 1985; 756: 1068-70.
  • Selbst SM, Ruddy RW, Clark BJ. Pediatric chest pain. Pediatrics 1988; 823: 319-23. 6. Day CP, Mc Comb JM, Campbell RWF. QT dispersion: an indication of arrhytmia risk in patient with long QT interval. Br Heart J 1990; 63: 342-4.
  • Pljevic D, Smalcelj A, Durakovic Z, Goldner V. QT dispersion, daily variations, QT interval adaptation and late potentials as risk markers for ventricular tachycardia. Eur Heart J 1997; 16: 1343-9.
  • Buja G, Mioreeli M, Turrini P, Melacini P, Nava A. Comparison of QT dipersion in hypertrophic cardiomyopathy between patients with and without ventricular arrhythmias and sudden death. Am J Cardiol 1993; 72: 973-6.
  • Duster MC. Chest pain. In: A Garson, JT Bricker, DT Fisher (eds). The Science and Practice of Pediatric Cardiology. 2nd edition. Baltimore: Williams and Wilkins, 1998: 2213-7.
  • Coleman WL. Recurrent chest pain in children. Pediatr Clin North Am 1984; 31: 1007-26.
  • Higham PD, Campbell RWF. QT dispersion. Br Heart J 1994; 71: 508-10.
  • Kuo CS, Reddy CP, Munokata K, Surawitcz B. Mechanism of ventricular arrhythmias caused by increased dispersion of repolarization. Eur Heart J 1985; 6 (Suppl D): 3-14.
  • Mirvis Dm. Spatial variation of Qt interval in normal persons and patients with acute myocardial infarction. J Am Coll Cardiol 1985; 3: 625-31.
  • Cowan JC, Yusoff DK, Moore M, et al. Importance of lead selection in QT interval measurement. Am J Cardiol 1988; 61: 83-7.
  • Stierle U, Giannitsis E, Sheikzadeh A, et al. Relation between QT dispersion and the extent of myocardial ischemia in patients with three-vessel coronary artery disease. Am J Cardiol 1998; 81: 564-8.
  • Dubin AM, Rosenthal DN, Chin C, Bernstein D. QT dispersion predicts ventricular arrhythmia in pediatric cardiomyopathy pati- ents referred for heart transplantation. J Heart Lung Transplant 1999; 18: 781-5.
  • Wolfram G, Steder U, Menz V, Hoffmann J, Maisch B. QT dispersion and arrhytmic events in idiopathic dilated cardiomyo- pathy. Am J Cardiol 1996; 78: 458-61.
  • Yetman AT, Hamilton RM, Benson LN, McCrindle BW. Long-term outcome and prognostic determinants in children with hypertrophic cardiomyopathy. J Am Coll Cardiol 1998; 32: 1943-50.
  • Tieleman RG, Crijns HJGM, Wiesfeld ACP, Posma J, Hamer HPM, Lie KI. Increased dispersion of refractoriness in the absence of QT prolongation in patients with mitral valve prolapse and ventricular arrhythmias. Br Heart J 1995; 73: 37-40.
  • Kulan K, Komşuoğlu B, Tuncer C, Kulan C. Significance of QT dispersion on ventricular arrhythmias in mitral valve prolapse. Int J Cardiol 1996; 54: 251-7.
  • Galinier M, Vialette JC, Fourcade J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure: importance of aetiology. Eur Heart J 1998; 19: 1054-62.
  • Savelieva I, Yi G, Guo X, Hnatkova K, Malik M. Agreement and reproducibility of automatic versus manual measurement of QT interval and QT dispersion. Am J Cardiol 1998; 81: 471-7.
  • Elming H, Holm E, Jun L, et al. The prognostic value of QT interval and QT interval dispersion in all-cause cardiac mortality and morbidity in a population of Danish citizens. Eur Heart J 1998; 19: 1391-400.
  • Sun ZH, Swan H, Viitasola M, Toivonen L. Effect of ephinephrine and phenylephrin on QT interval dispersion in congenital Long QT syndrome. J Am Coll Cardiol 1998; 31: 1400-5.
  • Rowland TW, Richards MM. The natural history of idiopathic chest pain in children. Clin Pediatr 1986; 26: 612-4.
  • Wiens L, Sabath R, Ewing L, Gowdamarajan R, Portnoy J, Scagliotti D. Chest pain in otherwise healthy children and adolecent is frequently caused by exersize induced astma. Pediatrics 1992; 90: 350-3.

Çocuklarda idiyopatik göğüs ağrısında EKG bulguları ve QT dispersiyonu Orijinal Araştırma

Year 2009, Volume: 44 Issue: 2, 53 - 56, 01.06.2009

Abstract

Amaç: Göğüs ağrısı çocuklarda sık görülen çoğunlukla nedenin gösterilemediği bir yakınmadır Erişkin hastalarda göğüs ağrısının koroner arter hastalığı ile bilinen ilişkisi hastalar ve aileleri üzerinde endişe yaratmaktadır Ciddi aritmi ve ani ölüm riskinin belirlenmesinde kullanılan QT dispersiyonu bu hasta grubunda çalışılmış ve bu hastaların kardiyak açıdan risk taşıyıp taşımadıkları araştırılmıştır Gereç ve Yöntem: Yaşları 5 15 arasında değişen ve göğüs ağrısı ile başvuran 10 kız ve 13 erkek yaşları 5 5 ile 15 arasında değişen ve masum üfürüm nedeni ile başvuran 21 erkek ve 7 kız olguda kontrol grubu kalp hızı RR mesafesi RR “variyabilitesi” PR aralığı P dalga yükseklik ve genişliği P aksı QRS zamanı QRS aksı QT aralığı düzeltilmiş QT aralığı QT dispersiyonu düzeltilmiş QT dispersiyonu 12 derivasyonlu EKG kayıtları üzerinde hesaplandı ve birbirleri ile karşılaştırıldı Bulgular: Hasta ve kontrol grupları arasında kalp hızı RR aralığı PR aralığı P dalgası genişliği QRS süresi QRS aksı QT aralığı ve düzeltilmiş QT aralığı yönünden anlamlı fark bulunmazken P dalgası yüksekliği hasta grubunda 1 6±0 6 ile kontrol grubundaki 1 3±0 04 değerine göre anlamlı olarak yüksek bulundu p=0 03 QT dispersiyonu hasta ve kontrol gruplarında sırasıyla 65±23 msn ve 61±17msn düzeltilmiş QT dispersiyonu da hasta ve kontrol gruplarında sırasıyla 106±2 msn ve 113±23 msn bulundu ve anlamlı fark saptanmadı Tüm derivasyonlarda sadece göğüs derivasyonlarında ve sadece ekstremite derivasyonlarında ölçülen QT dispersiyonu değerleri arasında iyi bir ilişki gözlendi r=0 47 p lt;0 005 ve r=0 24 p lt;0 02 Çıkarımlar: Sonuç olarak; çocukluk çağında göğüs ağrısı ani ölüm ve ciddi aritmi riski açısından normal toplumdan farklılık göstermemektedir P dalgası yüksekliğinin artmış olması bu hastalarda solunum işlevlerinin değerlendirilmesinin yararlı olacağını düşündürmektedir Türk Ped Arş 2009; 44: 53 6 Anahtar kelimeler: Aritmi elektrokardiyografi göğüs ağrısı QT dispersiyonu

References

  • Selbst SM. Evaluation of chest pain in children. Pediatr Rev 1986; 6: 56-62.
  • Kocis KC. Chest pain in pediatrics. Pediatr Clin North Am 1999; 46: 189-203.
  • Brenner JI, Ringel RE, Berman MA. Cardiologic perspectives of chest pain in childhood: A referral problem? To whom? Pediatr Clin North Am 1984; 31: 1241-58.
  • Selbst SM. Chest pain in children. Pediatrics 1985; 756: 1068-70.
  • Selbst SM, Ruddy RW, Clark BJ. Pediatric chest pain. Pediatrics 1988; 823: 319-23. 6. Day CP, Mc Comb JM, Campbell RWF. QT dispersion: an indication of arrhytmia risk in patient with long QT interval. Br Heart J 1990; 63: 342-4.
  • Pljevic D, Smalcelj A, Durakovic Z, Goldner V. QT dispersion, daily variations, QT interval adaptation and late potentials as risk markers for ventricular tachycardia. Eur Heart J 1997; 16: 1343-9.
  • Buja G, Mioreeli M, Turrini P, Melacini P, Nava A. Comparison of QT dipersion in hypertrophic cardiomyopathy between patients with and without ventricular arrhythmias and sudden death. Am J Cardiol 1993; 72: 973-6.
  • Duster MC. Chest pain. In: A Garson, JT Bricker, DT Fisher (eds). The Science and Practice of Pediatric Cardiology. 2nd edition. Baltimore: Williams and Wilkins, 1998: 2213-7.
  • Coleman WL. Recurrent chest pain in children. Pediatr Clin North Am 1984; 31: 1007-26.
  • Higham PD, Campbell RWF. QT dispersion. Br Heart J 1994; 71: 508-10.
  • Kuo CS, Reddy CP, Munokata K, Surawitcz B. Mechanism of ventricular arrhythmias caused by increased dispersion of repolarization. Eur Heart J 1985; 6 (Suppl D): 3-14.
  • Mirvis Dm. Spatial variation of Qt interval in normal persons and patients with acute myocardial infarction. J Am Coll Cardiol 1985; 3: 625-31.
  • Cowan JC, Yusoff DK, Moore M, et al. Importance of lead selection in QT interval measurement. Am J Cardiol 1988; 61: 83-7.
  • Stierle U, Giannitsis E, Sheikzadeh A, et al. Relation between QT dispersion and the extent of myocardial ischemia in patients with three-vessel coronary artery disease. Am J Cardiol 1998; 81: 564-8.
  • Dubin AM, Rosenthal DN, Chin C, Bernstein D. QT dispersion predicts ventricular arrhythmia in pediatric cardiomyopathy pati- ents referred for heart transplantation. J Heart Lung Transplant 1999; 18: 781-5.
  • Wolfram G, Steder U, Menz V, Hoffmann J, Maisch B. QT dispersion and arrhytmic events in idiopathic dilated cardiomyo- pathy. Am J Cardiol 1996; 78: 458-61.
  • Yetman AT, Hamilton RM, Benson LN, McCrindle BW. Long-term outcome and prognostic determinants in children with hypertrophic cardiomyopathy. J Am Coll Cardiol 1998; 32: 1943-50.
  • Tieleman RG, Crijns HJGM, Wiesfeld ACP, Posma J, Hamer HPM, Lie KI. Increased dispersion of refractoriness in the absence of QT prolongation in patients with mitral valve prolapse and ventricular arrhythmias. Br Heart J 1995; 73: 37-40.
  • Kulan K, Komşuoğlu B, Tuncer C, Kulan C. Significance of QT dispersion on ventricular arrhythmias in mitral valve prolapse. Int J Cardiol 1996; 54: 251-7.
  • Galinier M, Vialette JC, Fourcade J, et al. QT interval dispersion as a predictor of arrhythmic events in congestive heart failure: importance of aetiology. Eur Heart J 1998; 19: 1054-62.
  • Savelieva I, Yi G, Guo X, Hnatkova K, Malik M. Agreement and reproducibility of automatic versus manual measurement of QT interval and QT dispersion. Am J Cardiol 1998; 81: 471-7.
  • Elming H, Holm E, Jun L, et al. The prognostic value of QT interval and QT interval dispersion in all-cause cardiac mortality and morbidity in a population of Danish citizens. Eur Heart J 1998; 19: 1391-400.
  • Sun ZH, Swan H, Viitasola M, Toivonen L. Effect of ephinephrine and phenylephrin on QT interval dispersion in congenital Long QT syndrome. J Am Coll Cardiol 1998; 31: 1400-5.
  • Rowland TW, Richards MM. The natural history of idiopathic chest pain in children. Clin Pediatr 1986; 26: 612-4.
  • Wiens L, Sabath R, Ewing L, Gowdamarajan R, Portnoy J, Scagliotti D. Chest pain in otherwise healthy children and adolecent is frequently caused by exersize induced astma. Pediatrics 1992; 90: 350-3.
There are 25 citations in total.

Details

Primary Language Turkish
Journal Section Original Article
Authors

Figen Akalın This is me

Serap Turan This is me

Publication Date June 1, 2009
Published in Issue Year 2009 Volume: 44 Issue: 2

Cite

APA Akalın, F., & Turan, S. (2009). Çocuklarda idiyopatik göğüs ağrısında EKG bulguları ve QT dispersiyonu Orijinal Araştırma. Türk Pediatri Arşivi, 44(2), 53-56.
AMA Akalın F, Turan S. Çocuklarda idiyopatik göğüs ağrısında EKG bulguları ve QT dispersiyonu Orijinal Araştırma. Türk Pediatri Arşivi. June 2009;44(2):53-56.
Chicago Akalın, Figen, and Serap Turan. “Çocuklarda Idiyopatik göğüs ağrısında EKG Bulguları Ve QT Dispersiyonu Orijinal Araştırma”. Türk Pediatri Arşivi 44, no. 2 (June 2009): 53-56.
EndNote Akalın F, Turan S (June 1, 2009) Çocuklarda idiyopatik göğüs ağrısında EKG bulguları ve QT dispersiyonu Orijinal Araştırma. Türk Pediatri Arşivi 44 2 53–56.
IEEE F. Akalın and S. Turan, “Çocuklarda idiyopatik göğüs ağrısında EKG bulguları ve QT dispersiyonu Orijinal Araştırma”, Türk Pediatri Arşivi, vol. 44, no. 2, pp. 53–56, 2009.
ISNAD Akalın, Figen - Turan, Serap. “Çocuklarda Idiyopatik göğüs ağrısında EKG Bulguları Ve QT Dispersiyonu Orijinal Araştırma”. Türk Pediatri Arşivi 44/2 (June 2009), 53-56.
JAMA Akalın F, Turan S. Çocuklarda idiyopatik göğüs ağrısında EKG bulguları ve QT dispersiyonu Orijinal Araştırma. Türk Pediatri Arşivi. 2009;44:53–56.
MLA Akalın, Figen and Serap Turan. “Çocuklarda Idiyopatik göğüs ağrısında EKG Bulguları Ve QT Dispersiyonu Orijinal Araştırma”. Türk Pediatri Arşivi, vol. 44, no. 2, 2009, pp. 53-56.
Vancouver Akalın F, Turan S. Çocuklarda idiyopatik göğüs ağrısında EKG bulguları ve QT dispersiyonu Orijinal Araştırma. Türk Pediatri Arşivi. 2009;44(2):53-6.