Göğüs Ağrısı ile Çocuk Kardiyoloji Polikliniğine Başvuran Vakaların Etiyolojik Özellikleri

Öz

Amaç: Göğüs ağrısı çocuk popülasyonunda, özellikle adölesan dönemde çocuk kardiyoloji polkliniğine başvurularda önemli bir şikâyet bulgusudur. Çalışmanın amacı, göğüs ağrısı şikâyeti ile başvuran hastaların etiyolojik özelliklerinin sıklığını belirlemek bu konuda ekokardiyografinin önemini değerlendirmektir. Gereç ve Yöntemler: 2014-2019 yılları arasında Kırıkkale Üniversitesi Tıp Fakültesi Hastanesi Çocuk Kardiyoloji Kliniği’ne göğüs ağrısı şikâyeti ile başvuran hastaların etiyolojik ve epidemiyolojik özelliklerini retrospektif olarak inceledik. Bulgular: Bu çalışmaya bin yüz altmış dört hasta dahil edildi. Hastaların yaş ortalaması 12.9±2.0 (dağılım 10-17) idi. 1164 hastanın %87.9'una (n=1023) ekokardiyografik değerlendirme yapıldı. 769 (%75.2) hastada kardiyak anormallik yoktu. Mitral valv prolapsusu (MVP) 164 (%16.0) hastada saptandı. Bu hastaların 116'sında (%11.3) ayrıca mitral yetmezlik (MY) vardı. (117/164 (%71.4)). MVP'li hastalarda kadın üstünlüğü vardı (117/164, %71.4). Ekokardiyografi bulguları normal olan hastalar, ortalama hemoglobin (Hb), ortalama eritrosit hacmi (MCV), CK, CK-MB, Troponin, Pro-BNP ve CRP düzeyleri açısından MVP+MI olan hastalarla karşılaştırıldı. Bu parametreler açısından bu gruplar arasında anlamlı fark yoktu. Sonuç: Çocuklarda kardiyak ilişkili göğüs ağrısının en yaygın nedeninin MVP/MI olduğunu gösterdik. Bu nedenle özellikle üfürüm gibi fizik muayene bulgusu olan göğüs ağrısı, bir pediatrik kardiyolog tarafından ideal olarak ekokardiyografi ile değerlendirilmelidir.

Anahtar Kelimeler

• Göğüs ağrısı
• mitral valv prolapsusu
• kardiyak belirteçler

ETIOLOGICAL FEATURES OF CASES WITH CHEST PAIN IN THE PEDIATRIC CARDIOLOGY OUTPATIENT CLINIC

Öz

Objective: Chest pain in children, especially in adolescence, constitutes a significant proportion of the presentations to pediatric cardiology clinics. We aimed to determine the frequency of chest pain causes in the pediatric age group and the importance of echocardiography. Material and Methods: We retrospectively examined the etiological and epidemiological characteristics of patients with chest pain who were admitted to Kırıkkale University Medical Faculty Hospital Pediatric Cardiology Clinic and Pediatric Emergency Service between 2014 and 2019. Results: One thousand hundred sixty-four patients were enrolled in this study. The mean age of the patients was 12.9±2.0 years (range 10-17 years). Echocardiographic evaluation was performed in 87.9% (n=1023) of 1164 patients. In 769 (75.2%) patients, there was no cardiac abnormality. Mitral valve prolapse (MVP) was detected in 164 (16.0%) patients. Out of these patients, 116 (11.3%) also had mitral insufficiency (MI). There was a female preponderance (117/164, 71.4%) among the patients with MVP. Patients with normal echocardiography findings, were compared with patients who had MVP+MI with respect to mean hemoglobin, mean corpuscular volume, Creatine kinase, Creatine kinase- MB, troponin, pro-B-type natriuretic peptide, and C-reaktif protein levels. There was no significant difference between these groups with respect to these parameters. Conclusion: We showed that MVP/MI is the most common cause of cardiac related chest pain in children. Therefore, chest pain, especially with physical examination findings, such as a murmur, should be evaluated by a pediatric cardiologist, ideally by echocardiography.

Anahtar Kelimeler

• Chest pain
• mitral valve prolapse
• cardiac markers

Kaynakça

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