Diagnostic Evaluation of Children Presenting with Chest Pain to Pediatric Cardiology Clinic: Covid-19 Pandemic's Effect to Etiology

Öz

Aim: The aim of this study was to evaluate the etiology of chest pains and demographic data of these patients, and to investigate the effect of the COVID-19 pandemic on these variables. Material and Methods: The study included patients who presented with complaints of chest pain at the Paediatric Cardiology Clinic between November 2019 and August 2020. The patients were separated into two groups from the date of when restrictions to daily life were implemented because of the COVID-19 pandemic in Turkey, as Group 1 who presented before March 2020, and Group 2 who presented after March 2020. Results: Evaluation was made of a total of 251 patients comprising 136 (54.2%) females and 115 (45.8%) males with a mean age of 11.6 ± 2.9 years. The chest pain was felt most often in the precordial area (46.2%) as a needle pricking (64.9%). The cause of the chest pain was determined to be the musculoskeletal system (55%), psychogenic (16.3%) and idiopathic (13.5%) respectively. A cardiac reason was determined in 2.8% of the patients. In the comparisons of the two groups, psychogenic reasons were seen more in Group 2 after the pandemic, and more patients had been referred by a physician and from rural areas (p<0.05). Conclusion: To prevent repeated polyclinic presentations with non-cardiac chest pain, and unnecessary and lengthy tests, the concerns of families must be eliminated. After the beginning of the COVID-19 pandemic, there was determined to be an increase in children with chest pains of psychogenic cause.

Anahtar Kelimeler

• Chest pain
• COVİD-19
• Pandemic
• Psychogenic

Çocuk Kardiyoloji polikliniğine göğüs ağrısı şikayetiyle başvuran hastaların tanısal değerlendirilmesi: Covid 19 pandemisinin etiyolojiye etkisi.

Öz

Amaç: Çalışmamızda göğüs ağrılarını demografik ve etiyolojik açıdan değerlendirmeyi ve bu değişkenlere covid 19 pandemisinin etkisini araştırmayı amaçladık. Gereç ve Yöntem: Kasım 2019- Ağustos 2020 tarihleri arasında çocuk kardiyoloji polikliniğine göğüs ağrısı şikayetiyle başvuran hastalar çalışmaya alındı. Hastaların özgeçmiş ve soygeçmiş bilgileri, göğüs ağrısının özellikleri, fizik muayene bulguları, ekg ve ekokardiyografik bulguları kaydedildi. Hastalar Türkiye’de covid 19 pandemisi nedeniyle toplumsal yaşamda kısıtlamaların uygulanmaya başlandığı Mart 2020 öncesi (grup I) ve sonrası (grup II) olmak üzere iki gruba ayrıldı. Bulgular: Çalışmaya yaş ortalaması 11,6 ± 2,9 yıl olan 136’sı kız (%54,2) toplam 251 hasta alındı. Ebeveynlerin %46’sı, hastaların ise %12’si göğüs ağrısının kardiyak kökenli olduğunu düşünüyordu. Göğüs ağrısı en sık prekordiyal alanda (%46,2) ve iğne batar tarzda (%64,9) hissedilmekteydi. Hastaların 116’sında (%46,2) soygeçmişinde kalp hastalığı mevcuttu. Göğüs ağrısının en sık sırayla kas-iskelet sistemi (%55), psikojenik (%16,3) ve idyopatik (%13,5) sebepli olduğu görüldü. Hastaların %2,8’inde kardiyak sebep saptandı. Gruplararası karşılaştırmada pandemi sonrası (grup II) de psikojenik sebeplerin daha fazla olduğu, hastaların daha fazla hekim sevkiyle ve kırsaldan geldiği saptandı (p<0,05). Sonuç: Nonkardiyak göğüs ağrılarında tekrarlayan poliklinik başvuruları, gereksiz ve uzun süren tetkikleri önlemek için ailelerin endişeleri giderilmelidir. Covid 19 pandemisi sonrasında çocuklarda psikojenik nedenli göğüs ağrılarında artış saptandı.

Anahtar Kelimeler

• COVİD-19
• Göğüs ağrısı
• Pandemi
• Psikojenik

Kaynakça

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