Ayşe YILDIRIM, Ali BALIK, Deniz OĞUZ, Cihat SANLI, Oya BALCI

Geçici yaygın kardiyak iletim gecikmesi ile giden nadir bir olgu

Aritmiler, çocukluk döneminde eriskinlere göre daha az sıklıkta görülmektedir. Çocuklarda görülen en sık aritmi supraventriküler tasikardi olup, ani gelisen aritmilerde; ilaç alımları, akut gelisen elektrolit bozuklukları gibi nedenler akla getirilmelidir.Antrigribal ilaç kullanımı sonrasında kendini kötü hissetme, terleme ve karın ağrısıyakınmaları ile acil servisimize basvuran, elektrokardiyografisinde (EKG) yaygıniletim yavaslaması izlenen 13 yasındaki erkek hasta EKG’de saptanan iletim yavaslamasının bugüne kadar yayınlanan ve bilinen patolojilerin hiçbirisine uygunluk göstermemesi nedeniyle sunulmustur. Hastadaki bu tablo kullandığı ilaçların yan etkisiolarak (kalbin tüm uyarı ve iletim sisteminde genel bir yavaslama) açıklanmıstır. Anahtar Kelimeler: Aritmi, Antigribal İlaçlar,

Transient diffuse cardiac delayed conductance. A rare case report

Arrhythmias are seen less in children in comparison to the adult population. The mostsignificant arrhythmias that are seen in children are supraventricular tachycardia.The sudden onset of arrhythmias should alert the physician for differential diagnosisof various reasons including drug intoxications and acute electrolyte abnormalities.A 13-year-old boy presented to the emergencyclinic after the administration of anti-flu medications due to his not feeling well,sweating, and abdominal pain, and the ECG (electrocardiography) showed diffusedelayed conductance abnormality. This case report demonstrates an ECG finding thathas not been published in the literature and shows a delay in conductance that has notbeen observed before. The clinical status of this patient is considered to be relatedto the side effects of the medications (anti-flu medications) that caused the delayedconductance in the whole conductance system of the heart.

PDF

___

1. Kannakeril PJ, Fish FA. Disorders of cardiac rhythm and conduction. In Allen HD, Clark EB, Gutgesell HP, Driscoll DJ; Moss and Adams Heart Disease in Infants, Children, and Adolescents Including the Fetus and Young Adult. 7 edn. Baltimore: Williams & Wilkins, 2008, 1: 293-342.
2. Barold SS, Ilercil A, Leonelli F et al. First-degree atrioventricular block. Clinical manifestations, indications for pacing, pacemaker management & consequences during cardiac resynchronization. J Interv Card Electrophysiol 2006; 17:139-152
3. Chiang CE. Congenital and acquired long QT syndrome. Current concepts and management. Cardiol Rev 2004; 12:222-234
4. Dindar A. Çocukluk çağı aritmileri. Turkiye Klinikleri Turkiye J Int Med Sci 2005; 1:123-134
5. Oppenheimer E, Akavia E, Shavit S et al. Sympathomimetic amines and cardiac arrhythmias. Cardiovasc Res 1990;24:754–757.
6. Goldstein DR, Epstein AE. A shocking case of pseudoephedrine use. J Interv Card Electrophysiol. 1999;3:341-342.
7. Haroz R, Greenberg MI. New drugs of abuse in North America. ClinLab Med. 2006;26:147-164.
8. Dickerson J, Perrier D, Mayersohn M et al. Dose tolerance and pharmacokinetic studies of L(+) pseudoephedrine capsules in man. Europ J Clin Pharmacol. 1978:14;253-259
9. Kaltman J, Shah M. Evaluation of the child with an arrhythmia. Pediatr Clin N Am 2004:51;1537-1551