Göğüs Ağrısı ile Çocuk Kardiyoloji Polikliniğine Başvuran Olguların Epidemiyolojik, Etiyolojik ve Klinik Özellikleri
Abstract
Amaç: Göğüs ağrısı (GA), çocuk ve adölesanlarda sık görülmesine ve hasta ile ailenin kaygı duymasına neden olmasına rağmen, çoğu olguda etiyolojide organik bir sebep bulunmamaktadır. Çalışmamızda, GA nedeniyle başvuran çocuklarda epidemiyolojik, klinik özelliklerin ve etiyolojik nedenlerin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: GA sebebiyle çocuk kardiyoloji polikliniğine Ocak 2015-Mart 2017 tarihleri arasında başvuran olgular yaş, cinsiyet, başvuru dönemi gibi epidemiyolojik; ağrının süresi, şekli, yayılımı, eşlik eden semptomlar, fizik muayene ve laboratuvar bulguları gibi klinik özellikleri açısından retrospektif olarak incelendi.Bulgular: Göğüs ağrısı şikayeti ile başvuran 570 olgunun ortalama yaşı 11.6±3.5 yıldı. En az olgu 7 yaştan küçük grupta (n:48,%8), en fazla ise 7-12 yaş (n:270,%47) grubundaydı (p=0.01). Erkek olgular kızlardan daha fazla olmasına rağmen aralarındaki fark anlamlı değildi (p=0.8). GA’na yol açan en sık nedenler idiyopatik (n:328,%58) ve kas-iskelet sistemi (n:109,%19) olarak tespit edildi. Kardiyak nedenler (n:45,%8) literatüre kıyasla daha fazla olup en sık iki neden mitral kapak prolapsusu (MVP) (n:20,%44) ve romatizmal kardit (n:7,%15)’di.Sonuç: Çocuklarda GA’nın etiyolojik nedenleri arasında kardiyak kökenli GA %0-4 oranında görülmektedir. Çalışmanın yapıldığı merkeze göre etiyolojik nedenlerin sıklığı değişebilmektedir. Çalışmamızda kardiyojenik GA beklenenin iki katı yüksek sıklıkta tespit edilmiştir. Olguların farklı birimlerden ön değerlendirme sonrası yönlendirilmiş olması bu duruma sebep olabilir. Literatürde kardiyak GA nedenleri arasında romatizmal kardit oldukça nadir bildirilmiş ancak çalışmamızda ikinci en sık neden olarak tespit edilmiştir. Kardiyojenik nedenler arasında özellikle gelişmekte olan ülkelerde romatizmal kardit hatırlanmalıdır. GA’a sebep olabilecek psikojenik nedenlerin tespiti için hastalar daha ayrıntılı sorgulanmalıdır.
References
- Park MK. Kawasaki disease. Pediatric Cardiology for Practitioners. 5th ed. Philadelphia: Mosby Elsevier, 2008:606-19.
- Driscoll DJ, Glicklich LB, Gallen WJ. Chest pain in children: A prospective study. Pediatrics 1976;57:648.
Pain in the Pediatric Cardiology Outpatient Clinic Epidemiological, Etiologic and Clinical Features of Cases with Chest
Abstract
Objective: Chest pain (CP) is a common complaint in children and adolescents. In most cases, it is a cause for anxiety in the patient and the family even though there is no organic cause. The aim of our study was to evaluate the epidemiological, clinical features and etiologic reasons of CP in children.Material and Methods: Patients who presented to the pediatric cardiology outpatient clinic between January 2015 and March 2017 due to CP were included. Epidemiological factors such as age, sex and admission period and the clinical characteristics such as duration of pain, pattern, spread, accompanying symptoms, physical examination and laboratory findings were retrospectively analyzed.Results: The mean age of the 570 patients with CP complaint was 11.6 ± 3.5 years. The smallest number of cases were in the age group smaller than 7 years (n: 48, 8%) and the largest in the age group of 7-12 years (n: 270, 47%) (p=0.01). There were more males than females but the difference was not significant (p=0.8). The most common causes of CP were idiopathic (n: 328, 58%) and musculoskeletal (n: 109, 19%). Cardiac causes (n: 45, 8%) were more common than in the literature and the two most frequent causes were MVP (n: 20, 44%) and rheumatic carditis (n: 7, 15%).Conclusion: Cardiogenic CP is seen at a rate of 0-4% as the etiologic factor in children. The frequency of the causes can vary according to the center of the study. In our study, cardiogenic CP was detected at twice the rate expected. The fact that the cases are referred after the preliminary evaluation at different units may be the reason. In the literature, rheumatic carditis is rarely reported among the causes of cardiogenic CP, but it was the second most common reason of cardiogenic CP in our study. Among cardiogenic causes, rheumatic carditis should be remembered, especially in developing countries. Patients should be questioned in more detail to determine the psychogenic causes that may cause CP
References
- Park MK. Kawasaki disease. Pediatric Cardiology for Practitioners. 5th ed. Philadelphia: Mosby Elsevier, 2008:606-19.
- Driscoll DJ, Glicklich LB, Gallen WJ. Chest pain in children: A prospective study. Pediatrics 1976;57:648.
Details
| Other ID | JA58SB56SN |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | December 1, 2018 |
| Submission Date | December 1, 2018 |
| Published in Issue | Year 2018 Volume: 12 Issue: 3 |
The publication language of Turkish Journal of Pediatric Disease is English.
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