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Akut Pnömoni ve Bronşiyolitli Çocuklarda Elektrokardiyografik Anormallikler

Amaç: Bu prospektif çalışmada; pnömoni ve bronşiolitli çocuklarda elektrokardiyografik değişikliklerin sıklık ve özelliklerini araştırmayı amaçladık. Hastalar ve yöntem: Çalışmaya ortalama yaşları 25.8 ay (2-168) olan 48 alt solunum yolu enfeksiyonlu çocuk (27 erkek) dahil edildi. Bulgular: Elektrokardiyografideki en yaygın değişiklikler; QTc intervalinde uzama (%89.3), QRS aksında sağa kayma (%85.4), sağ ventrikül güçlerinde artış (%70.5), taşikardi (%64.5), P voltajında artma (%54.1) ve T supresyonu (%52.1) idi. Üç hastada sağ aks deviasyonu, üç hastada p pulmonale ve 12 hastada da QTc'de uzama gözlendi. QRS aksında sağa sapma, p pulmonale ve V1R/S oranında artış pnömonili çocuklarda bronşiolitli olanlara göre daha fazla oranda saptandı. Sonuç: Elektrokardiyografik değişikliklerin çocukluk çağı alt solunum yolu infeksiyonlarında yaygın ancak tamamen geri dönüşümlü olduğunu gösterdik. Akut alt solunum yolu infeksiyonlu çocuklarda kardiyak bulguları değerlendirirken, infeksiyon düzeldikten sonraki elektrokardiyografi ile karşılaştırılması uygun olacaktır. Anahtar Kelimeler Bronşiolit, Çocuk, Elektrokardiyografi, Infeksiyon, Pnömoni

Anahtar Kelimeler:

Bronşiolit, Çocuk, Elektrokardiyografi, Infeksiyon, Pnömoni

Electrocardiographic Abnormalities of Acute Pneumonia and Bronchiolitis in Children

Backgrounds: This prospective study was performed to determine the frequency and characteristics of electrocardiographic abnormalities in pneumonia and bronchiolitis. Patients and method: Study included 48 children (27 male) with a mean age of 25.8 months (2-168), who were admitted due to pneumonia and bronchiolitis. Results: The most common changes on electrocardiography were prolongation in QTc interval (89.3%), rightward deviation of QRS axis (85.4%), enhance in right ventricular forces (70.5%), tachycardia (64.5%), elevation in P voltages (54.1%), and supression in T voltages (52.1%). Three patients had right axis deviation (according to age), three patients had p pulmonale (p voltage >2.5 mm) and 12 patients had QTc prolangation (QTc >440 ms) on their first electrocardiographies. Rightward deviation in QRS axis, increase in P wave voltage and elevation of V1R/S ratio were more common in infants with pneumonia compared to those with bronchiolitis. Conclusion: Electrocardiographic abnormalities are common but completely reversible in respiratory tract infections. While evaluating cardiovascular status of a child with respiratory disease, it is advisable to reinterpret the electrocardiography after recovery. Key Words Bronchiolitis, Child, Electrocardiography, Infection, Pneumonia

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Corresponding Author: Yılmaz TABEL, MD,
Inonu Universitesi Faculty of Medicine
Department of Pediatrics
MALATYA-TURKEY Phone: +90 422 377 5301
Fax: +90 422 341 0728
E-mail: yilmaztabel@yahoo.com