BİLİNEN KALP HASTALIĞI ÖYKÜSÜ OLMAYAN ÇOCUKLARDA ELEKTROKARDİYOGRAM AKS DEĞERLERİNİN KONJENİTAL KALP HASTALIĞINI ÖNGÖRMEDEKİ ETKİSİ

Amaç: Bu çalışmada Elektrokardiyografi (EKG)’de ölçülen aks değerlerinin çocuklarda Konjenital Kalp Hastalığı(KKH) tanısını saptamadaki öngörüsü araştırıldı. Materyal ve Metot: Çocuk kardiyolojisi polikliniğine başvuran ve öncesinde bilinen kalp hastalığı öyküsü bulunmayan, yaşı >1 ay ile 0.05)ancak ekokardiyografide konjenital kalp hastalığını görülmesini anlamlı artırmaktaydı(p

The Effect of Axis Values on Electrocardiography in Prediction of Congenital Heart Diseases in Children without a Known History of Heart Disease

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

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1. Tworetzky W, McElhinney DB, Brook MM,Reddy VM, Hanley FL, Silverman NH. Echocardiographic diagnosis alone for the complete repair of major congenital heart defects. J Am Coll Cardiol. 1999;33(1):228–33.
2. Frommelt P. Update on pediatric echocardiography. Curr Opin Pediatr 2005; 17(5):579–85.
3. Fisch C. Centennial of the string galvanometer and the electrocardiogram.J Am Coll Cardiol. 2000;36(6):1737–45.
4. Ravi P, Ashwath R, Strainic J, Li H, Steinberg J, Snyder C. Clinical and financial impact of ordering an echocardiogram in children with left axis deviation on their electrocardiogram. Congenit Heart Dis 2016;11(2):110–14.
5. Schneider AE, Cannon BC, Johnson JN, Ackerman MJ,Wackel P. Left Axis Deviation in Children Without Previously Known Heart Disease. Pediatrics. 2018;141(3):e20171970.
6. Davignon A, Rautaharju P, Boisselle E, Soumis F, Megelas M, Choquette A. Normal ECG standards for infants and children. Pediatr Cardiol 1980;1(2):123–31.
7. Bu G, Miao Y, Bin J,. Comparison of 128-slice low-dose prospective ECG-gated CT scanning and trans-thoracic echocardiography for the diagnosis of complex congenital heart disease. PLoS One. 2016;11(10):e0165617.
8. Marek J, Skovránek J, Hucín B, Chaloupecký V, Tax P, Reich O, Samánek M. Seven-year experience of noninvasive preoperative diagnostics in children with congenital heart defects: comprehensive analysis of 2,788 consecutive patients. Cardiology 1995;86(6):488-95.
9. Advani N, Menahem S, Wilkinson JL. The Diagnosis of innocent murmurs in childhood. Cardiol Young. 2000;10(6):340-42.
10. Hansen LK, Birkebaek NH, Oxhoj H. Initial evaluation of children with heart murmurs by the nonspecialized pediatrican. Eur J Pediatr. 1995;154(1):15-7.
11. Rajakumar K, Wiesse M, Rosas A, Erdoğan G, Pyles L. Comparative study of clinical evaluation of heart murmurs by general pediatricians and pediatric cardiologist. Clinical Pediatrics. 1999;38(9):511-8.
12. Kamasak T,Dilber E. Çocukluk Çağındaki Masum Üfürümlerin Tanısında Fizik Muayene, Elektrokardiyografi, Telekardiyografi ve Ekokardiyografinin Yeri. Online Türk Sağlık Bilimleri Dergisi 2019;4(3): 360-76.
13. McElhinney DB, Straka M, Goldmuntz E, Zackai EH. Correlation between abnormal Cardiac physical examination and echocardiographic findings in neonates with Down syndrome. American ,Journal of Medical Genetics. 2002; 113(3):238-41.
14. Tanawuttiwat T, Vasaiwala S, Dia M. Mirror mirror (ECG image of the month) Am J Med. 2010;123(1):34–6.
15. Kurbel: A vector-free ECG interpretation with P, QRS & T waves as unbalanced transitions between stable configurations of the heart electric field during P-R, S-T & T-P segments. Theoretical Biology and Medical Modelling 2014; 11(1):10.
16. Rautenburg HW, Wagner R .Left anterior hemiblock (left axis deviation) in the ECG of children before and after heart surgery. Klin Padiatr 1983;195(4):256–62.
17. Moraes DN, Nascimento BR, Beaton AZ. Value of the Electrocardiographic (P Wave, T Wave, QRS) Axis as a Predictor of Mortality in 14 Years in a Population With a High Prevalence of Chagas Disease from the Bambuí Cohort Study of Aging. Am J Cardiol. 2018;121(3):364-69.