Göğüs ağrısı olan mitral kapak prolapsuslu çocuk hastalarda gastroözofageal reflü birlikteliği

Giriş ve Amaç: Göğüs ağrısı ve mitral kapak prolapsusu olan çocuklarda fonksiyonel gastrointestinal hastalıkların göğüs ağrısıyla ilişkisini araştıran az sayıda çalışma vardır. Bu çalışmada mitral kapak prolapsusu olan çocuklarda göğüs ağrısı ve gastroözofageal reflü hastalığı arasındaki ilişkiyi tanımlamayı amaçladık. Gereç ve Yöntem: Çalışmaya, tipik üst gastrointestinal sistem semptomları ve göğüs ağrısı tanımlayan, hafif ile orta mitral kapak prolapsusu olan 70 çocuk hasta dahil edildi. Hastalar sekiz hafta süreyle anti-reflü ilaç tedavisi ile tedavi edildi. Tedaviden önce ve sonra hastalar gastroözofageal reflü hastalığı etki ölçeği ile değerlendirildi. Bulgular: Hastaların yaş ortalaması 13.24±2.81 yıldı ve 32'si (%60) kızdı. 30 hastanın semptomları 6 haftadan daha fazla ve 40 hastanın semptomları 6 haftadan az süredir mevcuttu. Tüm hastaların ortalama semptom süresi 8±2.2 haftaydı. En çok bildirilen semptom göğüs ağrısı (%89.9) ve ardından regürjitasyon (%50) idi. Kronik gastroözofageal reflü olan çocuklarla karşılaştırıldığında, yeni gastroözofageal reflü tanısı alan çocuklarda anlamlı olarak daha sık ve ciddi semptomlar vardı. Mitral kapak prolapsusunun şiddeti ile semptomlar arasında anlamlı bir ilişki bulunmadı. Gastroözofageal reflü hastalığı etki ölçeği skorları, tedaviden sonra tüm hastalarda istatistiksel olarak azalmıştı (p <0.01). Her iki hasta grubu tedaviden fayda sağlasa da, gastroözofageal reflü hastalığı yeni saptanan hastalar, kronik hastalardan daha fazla tedaviden fayda gördüler. Sonuç: Mitral kapak prolapsusu ve göğüs ağrısı olan birçok çocuk hastada semptomatik gastroözofageal reflü hastalığı mevcuttur. Gastroözofageal reflünün spesifik tanısı ve tedavisi çoğu hastada göğüs ağrısını hafifletmiştir.

Association of gastroesophageal reflux and chest pain in children with mitral valve prolapse

Background and Aims: To date, few studies have investigated the association of pediatric functional gastrointestinal diseases with mitral valve prolapse and chest pain. We aimed to describe the relationship between chest pain and gastroesophageal reflux disease in children with mitral valve prolapse. Materials and Methods: This study included 70 pediatric patients with mild-to-moderate mitral valve prolapse with complaints of typical upper gastrointestinal system symptoms and chest pain. The patients were treated with medical anti-reflux drug therapy for 8 weeks. Before and after treatment, the patients were assessed with the Gastroesophageal Reflux Disease Impact Scale. Results: The mean patient age was 13.24±2.81 years, and 42 (60%) patients were female. The duration of symptoms in 30 patients was longer than 6 weeks, and that of 40 patients was shorter than 6 weeks. The mean symptom duration of all patients was 8±2.2 weeks. The most frequently reported symptom was chest pain (89.9%), followed by regurgitation (50%). Compared with children who had chronic gastroesophageal reflux, children with recent, acute gastroesophageal reflux reported significantly more frequent and severe symptoms. There was no significant relationship between the severity of mitral valve prolapse and symptoms. Gastroesophageal Reflux Disease Impact Scale scores of all patients were significantly decreased after treatment (p < 0.01). Although both groups of patients benefited from treatment, it was found that patients with newly diagnosed gastroesophageal reflux disease benefited significantly more from treatment than patients with chronic disease. Conclusion: Many preadolescents and adolescents with mitral valve prolapse and chest pain had symptomatic gastroesophageal reflux disease. Specific diagnosis and therapy for gastroesophageal reflux disease alleviated chest pain in most patients.

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