چاپ صفحه |  صفحه نخست سامانه |  نویسندگان |  اطلاعات تفضیلی |  دانلود مقاله | دانشگاه علوم پزشکی تبریز |
| نویسنده | نفر چندم مقاله |
|---|---|
| شهرام صادق وند | اول |
| عنوان | متن |
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| خلاصه مقاله | According to the results obtained in this study, it can be concluded that the use of an appropriate history and clinical examination along with ECG is of great value in the diagnosis of syncope with cardiovascular causes in children. It is also best to have echocardiography for all patients who are suspected and have an abnormal ECG. It was also observed in this study that the main defaults of cardiac syncope include early syncope with common periods, abnormal ECG, and higher sitting and standing blood pressure differences. demographic findings In this cross-sectional study, 100 children who referred to a clinic of referral children's hospital with at least one episode of syncope were studied. The mean age of the children was 8.54±2.70 years ranging from 2.5 to 16 years. The average number of syncope episodes was 4 episodes with a range between 1 and 12 episodes. In terms of gender distribution, 44 patients [44%] were boys and 56 [56%] were girls. Syncope related factors In a review of the clinical records of the patients, 70 children [70%] had experienced syncope for the first time, while 30 children [30%] had at least one history of syncope and were chronically ill. The family history of syncope was positive in 7 children[7%]. In addition, none of the children studied had a family history of cardiovascular diseases or sudden death. The most common cause of syncope in children was exercise-related syncope, which accounted for 33% [33%]. Examination of the early clinical signs of syncope (aura) in the studied children showed that the most common symptom was palpitation, which had a frequency of 29%. The frequency of early clinical signs of syncope in children is shown in Table 1. Also, in 38% of patients no clinical symptoms were reported at the time of syncope.Frequency of leading causes, early clinical signs, and blood pressure differences in children with syncope. Physical examination findings Clinical examination of patients showed that the average heart rate of patients was 107.03±17.49 beats/min with a range between 67 and 158. The mean systolic blood pressure of patients in the sitting and at standing positions were 101.3± 12.4 mmHg with a range between 74 to 144 mm Hg, and 105.7±13.4 mmHg with a range of 77 to 145 mm Hg, respectively. The mean diastolic blood pressure of patients in the sitting and standing positions were 66.4±10.5 mmHg with a range between 40 to 99 mm Hg, and 64.3±9.4 mmHg with a range of 44 to 90 mm Hg, respectively. 19 patients [19%] had murmur on clinical examination. ECG findings Abnormal ECG was observed in 11 patients [11%]; while the frequency of abnormalities was as follows: Prolonged QTc in 4 cases, ventricular hypertrophy based on high voltage in 2 cases, atrial enlargement in 2 cases, abnormal axis in 1 case, complete heart block in 1 case, and supraventricular tachycardia in 1 case. Also, a comparison of clinical examination findings based on syncope-related factors as well as heart rate and blood pressure based on ECG results is shown in Table 3. All of the patients with chronic syncope had normal ECG; while 15.7% of patients with acute syncope had abnormal ECG findings, which was significantly different [P=0.003]. The results also showed that patients with abnormal ECG results had significantly higher diastolic blood pressure at sitting, lower orthostatic systolic pressure, and lower orthostatic diastolic pressure. Echocardiography A total of 24 patients underwent echocardiography, of which 4 cases [16.7%] had abnormal results. Abnormalities included one case of dilated cardiomyopathy, one case of hypertrophic cardiomyopathy, one case of mitral prolapse, and one case of mitral valve regurgitation. In two of these patients, the ECG result was ormal, which included one case of mitral prolapse and one case of mitral valve regurgitation. There was a significant relationship between abnormal ECG results and abnormal echocardiographic results |
| کلمات کلیدی | Syncopeو Cardiac Findingsو Childhood |
| نام فایل | تاریخ درج فایل | اندازه فایل | دانلود |
|---|---|---|---|
| Safh.jpg | 1403/07/08 | 158426 | دانلود |
| Article.jpg | 1403/07/08 | 247034 | دانلود |
| Govahi.jpeg | 1403/07/08 | 113609 | دانلود |
