Bilinen Kalp Hastalığı Öyküsü Olmayan Çocuklarda Elektrokardiyogram Aks Değerlerinin Konjenital Kalp Hastalığını Öngörmedeki Etkisi

Yıl 2020, , 464 - 470, 20.12.2020

Gülhan Tunca Şahin , Erkut Ozturk

https://doi.org/10.37696/nkmj.768667

Öz

Giriş ve Amaç: Bu çalışmada Elektrokardiyografi
(EKG)’de ölçülen aks değerlerinin çocuklarda Konjenital Kalp Hastalığı(KKH)
tanısını saptamadaki öngörüsü araştırıldı.

Materyal ve Method:Çocuk kardiyolojisi polikliniğine
başvuran ve öncesinde bilinen kalp hastalığı öyküsü bulunmayan, yaşı >1 ay
ile <16 yaş arasındaki çocuklar çalışmaya alındı.Fizik muayenede patoloji
varlığı, EKG’de P,QRS,T aksı ve QRS-T açısı değerleri ve ekokardiyografide
konjenital kalp hastalığı varlığı araştırıldı.Sonuçlar istatistiksel olarak
değerlendirildi.

Bulgular: Çalışma döneminde 260 olgu
mevcuttu. Median yaş 24 ay(1 -160 ay) idi.Yapılan kardiyovasküler sistem fizik
muayenesinde % 45 olgu normal olarak değerlendirildi. Yüzde 40 olguda üfürüm ve
yüzde 15 olguda üfürüme ek olarak diğer patolojik bulgular görüldü.EKG’de 5 olguda
anormal P aksı, 23 olguda sol aks deviasyonu,29 olguda sağ aks deviasyonu, 3
olguda süperior aks,18 olguda anormal T aksı ve 32 olguda patolojik QRS-T açısı
saptandı.

Yapılan ekokardiyografide 68 olguda
konjenital kalp hastalığı saptandı.Fizik muayenede patoloji varlığı EKG aks
değerlerini ve QRS-T açısındaki anormal değişiklikleri etkilemiyordu(p>0.05)ancak
ekokardiyografide  konjenital kalp
hastalığını görülmesini anlamlı artırmaktaydı(p<0.05).Konjenital kalp
hastalığı varlığı EKG’de P,QRS ve  T
aksları açısından farklı değildi.Özellikle sol aks deviasyonu,QRS-T açısında
patoloji olma durumu ve anormal T açısı 
olan olgularda konjenital kalp hastalığı görülme olasılığı anlamlı
olarak yüksek bulundu(p<0.05).

Sonuç:Kardiyovaskuler sistem muayenesinde
patolojik dinleme bulguları gözlenen, EKG’de sol aks deviasyonu görülen veya
QRS-T açısının patolojik saptandığı çocuk olgular transtorasik ekokardiyografi
ile değerlendirilmelidir.

Anahtar Kelimeler

çocuk, elektrokardiyografi, konjenital, kalp hastalığı

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

-

The effect of axis values on electrocardiography in prediction of congenital heart diseases in children without a known history of heart disease

Öz

Objective:In this study,the
predictive value of electrocardiography(ECG) axis measurements at diagnosis of congenital
heart diseases(CHD) were evaluated in children.

Material and
Method:The children
between 1 month and 16 years of age without a known history of CHD who applied
to pediatric cardiology outpatient clinic were included in the study.Pathology
at physical examination,P,QRS,T axis and QRS-T angle values and the diagnosis
of a CHD at echocardiography were evaluated.Results were evaluated
statistically.

Results:Two hundred and sixty cases were
evaluated during the study period.Median age was 24 months(1-160months).The 45%
of the patients were evaluated as normal at cardiovascular system examination.Murmur
was present in 40% of the patients and other pathologic findings additionally
to the murmur were found in another 15% of the patients.ECG evaluations
revealed abnormal P axis in 5 patients,left axis deviation in 23 patients,right
axis deviation in 29 patients, superior axis in 3 patients,abnormal T axis in
18 patients and pathologic QRS-T angle in 32 patients.Echocardiographic stuies
revealed CHD at 68 patients.The pathology at physical examination did not
effect the ECG axis values and the abnormal changes at QRS-T angle(p>0.05)but
signicantly increasing the frequency of CHD diagnosis at
echocardiography(p<0.05).The presence of CHD was not found different in
terms of P,QRS and T axis.Congenital heart disease was found
significantly higher in patients especially with left axis deviation,QRS-T angle
pathology and abnormal T axis(p<0.05).

Conclusion:Children
with pathological auscultation findings at the cardiovascular system
examination, left axis deviation or pathological QRS-T angle at ECG should be
evaluated by transthoracic echocardiography.

Anahtar Kelimeler

child, electrocardiography, congenital, heart diseases

Proje Numarası

yok

Kaynakça

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