Çocuklarda Göğüs Ağrısı Anksiyöz Hastalıkların Belirtisi Olabilir Mi ?

Öz

Amaç:

Göğüs ağrısı çocuklarda, ergenlerde yaygın bir şikayettir ve sık acil servis başvurusuyla birlikte ileri testler yapılmasına neden olur. Bu çalışmada, çocuklarda genel anksiyete, kalp odaklı kaygı ve nonkardiyak göğüs ağrısı (NCCP) arasındaki ilişkinin irdelenmesi amaçlanmıştır. Bu değerlendirme ile olası psikolojik rahatsızlığı öngörme ve gereksiz tıbbi testlerden kaçınma sağlanabilecektir.

Yöntem:

Bu prospektif vaka kontrol çalışmasında, göğüs ağrısı şikayetleri ile pediatrik kardiyolojiye başvuran ve tıbbi bir patoloji tespit edilmeyen olgular çalışma grubunu oluştururken (n:73), göğüs ağrısı şikayeti ve sistemik rahatsızlığı bulunmayan olgular ise kontrol grubu olarak belirlendi (n: 26). Her olguya Beck Anksiyete Ölçeği (BAI) yapıldı, göğüs ağrısı olan çalışma grubuna ise ayrıca Kardiyak Anksiyete Ölçeği (CAQ) uygulandı.

Bulgular:

Elli altı hastanın (% 76.7) toplam BAI skoru 22 ve üzerinde idi. Çalışma ve kontrol grubu arasındaki BAI puanları arasında istatistiksel olarak anlamlı fark bulundu (p <0.001). CAQ’nun üç alt ölçeği (korku, dikkat ve kaçınma) genel kaygı ile yüksek korelasyona sahipti. CAQ için Cronbach alfa değeri olan 0.834, iç tutarlılık için tatmin edici bir rakam olarak tespit edildi.

Sonuç:

Bu ön çalışma sonucu, nonkardiyak göğüs ağrılı çocuklarda, anksiyete bozukluklarının öngörülenden daha yaygın olduğunu düşündürmektedir. İdiyopatik göğüs ağrısı olgularının çoğunda da psikolojik bir rahatsızlık olabileceği, bu nedenle göğüs ağrısı bulunan çocukların bir psikiyatriste yönlendirilmesi önerilmektedir. Çalışmamız, çocukluk çağı göğüs ağrılarında, CAQ kullanan ilk çalışma olması nedeniyle de önem taşımaktadır.

Anahtar Kelimeler

• Anksiyete,çocuk,adölosan,göğüs ağrısı

Can Chest Pain Be Accepted A Sign of Anxious Disorders in Children ?

Abstract

Objective:

Chest pain is a common complaint in children and adolescents, accounting for numerous emergency visits and leading to a wide range of testing. In this study we sought to determine general anxiety, heart-focused anxiety and their relationship among children with non-cardiac chest pain (NCCP). This assessment provides to predict a possible psychological disorder and avoid unnecessary further medical testing.

Method:

In this prospective case-control study, all patients aged 10-18 years old who were referred pediatric

cardiology with a complaint of chest pain and showed no evidence of obvious medical pathology (n:73) were selected for study group. Also cases who had no chest pain or cardiac disease were accepted as control group (n:26). Each case was interviewed with using Beck Anxiety Inventory (BAI) and patients with chest pain were also interviewed with Cardiac Anxiety Questionnaire (CAQ).

Results:

Fifty-six patients (76.7%) had high BAI scores with a total score of 22 and above. Statistically significant difference was found between BAI scores of study group and control group (p< 0.001). CAQ’s all three subscales (fear, attention and avoidance) were highly correlated with indicators of general anxiety. Cronbach’s alpha for CAQ was 0.834, indicating satisfactory internal consistency.

Conclusion:

The results of this preliminary study suggest that anxiety disorders are more common than predicted in children with NCCP. We believe that most idiopathic chest pain cases have an underlying psychological disorder especially anxious disorder therefore referring to a psychiatrist is suggested. Our study also should take a worthy of particular attention because of being the first study that use CAQ in pediatric clinical practice.

Keywords: Anxiety, children, adolescent, chest pain

Keywords

• Anxiety,children,adolescent,chest pain

Kaynakça

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