The clinical analysis of hypertrophic cardiomyopathy in children
10.3760/cma.j.issn.1673-4912.2014.03.004
- VernacularTitle:儿童肥厚型心肌病临床分析
- Author:
Qin WANG
;
Yue YUAN
- Publication Type:Journal Article
- Keywords:
Hypertrophic cardiomyopathy;
Children
- From:
Chinese Pediatric Emergency Medicine
2014;21(3):140-142
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics,diagnosis,treatment and prognosis of hypertrophic cardiomyopathy(HCM) in children.Methods Twenty-five cases of children confirmed with HCM in Beijing Children's Hospital from October 2000 to September 2013 were analyzed retrospectively through their clinical manifestations,laboratory tests,treatment and prognosis.Results HCM was found to be more common in older children.The average age of the patients in the studied cases was 8 years and 9 months and the male to female ratio was 3.1:1.Their clinical manifestations were as the follows:5 cases with shortness of breath and fatigue,4 cases with chest tightness and long breath,3 cases with precordial discomfort,5 cases with cough and wheezing and found to have cardiac abnormalities,8 cases found with asymptomatic heart murmurs with no other symptom,2 cases with syncope episodes,6 cases with a clear HCM family history,3 cases with a family history of infant deaths (specific condition not clear).ECG:18 cases showing left ventricular and/or right ventricular hypertrophy and ST-T changes,3 cases showing abnormal Q waves,2 cases showing ST-T changes,2 cases with Ⅰ ° atrio-ventricular block,1 case with left bundle branch block,and 1 case with left anterior division block.Cardiac enzymes were elevated in 5 cases.Chest X-rays showed enlarged heart shadow in 17 cases.Echocardiography revealed non-obstructive hypertrophic cardiomyopathy in 23 cases and obstructive hypertrophic cardiomyopathy in 2 cases.Left ventricular systolic function was decreased in 2 cases,and diastolic dysfunction in 3 cases.Twenty-one patients took oral metoprolol,1 patient took verapamil,1 patient took propranolol and 2 patients took no medication.The follow-up period of 2 months to 13 years witnessed 2 cases of death and 23 cases of survival.Conclusion HCM in children lacks specific clinical manifestations and the conditions of the patient are usually severe with progressive development.HCM is one of the main reasons of sudden death in adolescent,with poor prognosis.