Case of The Month

Öz

Breath holding spells are common in infancy and such children are frequently referred to physicians for exclusion of heart disease Iron deficiency anemia is commonly associated with these spells However autonomic dysregulation increased vagal stimulation leading to cardiac arrest and cerebral ischemia are considered as causes of the clinical situation Subsequent development of epilepsy and neurocardiogenic syncope are reported in patients with breath holding spells The aim of our study was to investigate QT dispersion for assessment of the risk of lethal dysrythmia and sudden death in this patient group The study group consisted of 9 girls and 6 boys between 8 42 months of age mean±SD=19 1±10 4 months ; and the control group consisted of 9 girls and 10 boys between 10 36 months of age mean±SD=21 9±8 9 months QT interval was measured corrected QT interval QTc QT dispersion QTd and QTc dispersion QTcd were calculated from 12 lead surface electrocardiograms of the patients and the control group There was no statistically significant difference in terms of QT and QTc intervals between the patient and the control groups while QTd and QTcd values were significantly increased in patients with breath holding spells compared to the healthy children QT dispersion value were 65 3±27 7 msn and 44 2±10 7 msn respectively in patients and controls p lt;0 01 QTc dispersion walue were 116 0±38 3 msn and 90 2±29 3 respectively p lt;0 05 In conclusion increased QT dispersion indicates non homogeneous repolarization of the ventricles in patients with breath holding spells and justifies further investigation for the risk of dysrhythmia and sudden death in this patient group Key words: breath holding spells dysrhythmia QT dispersion

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Ayın Olgusu

Öz

Kaynaklar1 Waldhausen JHT Holterman MJ Sawin RS: Surgical implications of necrotizing fasciitis in children with chickenpox J Pediatr Surg 1996; 31: 1138 41 2 Brogan TV Nizet V: A clinical approach to differentiating necrotizing fasciitis from simple cellulitis Infections in Medicine 1997; 14: 734 8 3 Floret D: Virus bacteria co infections Archives de Pediatrie 1997; 4: 1119 24 4 Sawin RS Schaller RT Tapper DT et al: Early recognition of neonatal abdominal wall necrotizing fasciitis Am J Surg 1994; 167: 481 4 5 Kosloske AM Cushing AH Borden TA et al: Cellulitis and necrotizing fasciitis of the abdominal wall in pediatric patients J Pediatr Surg 1981; 16: 246 51 6 Laupland KB Davies HD Low DE et al: Invasive group a streptococcal disease in children and association with varicella zoster virus infection Pediatrics 2000; 105: 601 7 7 Erdmann D Zamboni WA Husman J et al: Hyperbaric oksigen therapy improves outcome of streptococcal myositis in mice Undersea Hyperb Med 1995; 22S: 13 nbsp;

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