Document Type : Original Article

Authors

1 School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

BACKGROUND: Chest pain is a common complaint among children referred to treatment centers. This study aimed to investigate the electrocardiographic changes in children aged 5-15 years with chest pain referred to Hajar and Imam Ali Hospitals of Shahrekord.
METHODS: In this descriptive-analytic study, 350 children with chest pain who were referred to Hajar and Imam Ali Hospitals were included. After clinical examination, electrocardiography was performed. Echocardiography was conducted in cases with electrocardiographic changes, and CPK-MB and troponin I tests were performed if required. Data were analyzed using SPSS-22 software.
RESULTS: The children’s ages ranged from 5 to 15 years, with a mean of 10.6 ± 2.7 years. Abnormal electrocardiographic findings were observed in 28 (8%) of the 350 children. Findings included left axis deviation (2.6%), ST elevation (2.9%), ST depression (0.3%), shortened PR interval (0.9%), delta wave changes (0.06%), and cardiac hypertrophy (0.9%). Echocardiography was performed in 70 cases (23.33%), of which 28 (40%) were normal and 42 (60%) had abnormal findings. Mild changes were observed in 39 cases (55.7%), moderate changes in 2 cases (2.9%), and elevated pulmonary arterial pressure in 1 case (1.4%). Thirty girls (8.5%) and 12 boys (3.4%) experienced tachycardia, while 1 boy (0.2%) presented with bradycardia. Troponin I tests were conducted on 2 boys, with both results being negative.
CONCLUSION: Given the importance of heart disease, electrocardiography is recommended for all children presenting with chest pain. Electrocardiography may also serve as a valuable tool for screening heart disease in such cases.

Keywords

1. Kändler L, Schlez M, Weil J. Chest pain. Cardiol Young. 2017 Jun 2;27.
2. Aygun E, Aygun ST, Uysal T, Aygun F, Dursun H, Irdem A. Aetiological evaluation of chest pain in childhood and adolescence. Cardiol Young. 2020;30(5):617-23. https://doi.org/10.1017/s1047951120000621
3. Khella R. Rule Based System for Chest Pain in Infants and Children. Int J Engineer Inform System. 2016;1(4):138-48.
4. Ramagopal G, Narayana G, Devi U, Nayar P. Approach to chest pain in children and adolescents. Chett Health Cit. 2016;2(7):76-84.
5. Khalilian MR, Emami Moghadam A, Torabizadeh M, Khalilinejad F, Moftakhar S. Pediatric and adolescent chest pain: a cross sectional study. Int J Pediat. 2015;3(1.2):435-40. https://doi.org/10.22038/ijp.2015.3911
6. Leifer G, Keenan-Lindsay L. Leifer’s Introduction to Maternity & Pediatric Nursing in Canada E-Book: Elsevier Health Sciences; 2019.
7. Danduran MJ, Earing MG, Sheridan DC, Ewalt LA, Frommelt PC. Chest pain: characteristics of children/adolescents. Pediatr Cardiol. 2008 Jul;29(4):775-81. https://doi.org/10.1007/s00246-008-9200-9
8. Reddy SR, Singh HR. Chest pain in children and adolescents. Pediatr Rev. 2010 Jan;31(1):e1-9. https://doi.org/10.1542/pir.31-1-e1
9. Lin CH, Lin WC, Ho YJ, Chang JS. Children with chest pain visiting the emergency department. Pediatr Neonatol. 2008 Apr;49(2):26-9. https://doi.org/10.1016/s1875-9572(08)60007-8
10. Chun JH, Kim TH, Han MY, Kim NY, Yoon KL. Analysis of clinical characteristics and causes of chest pain in children and adolescents. Korean J Pediatr. 2015 Nov;58(11):440-5. https://doi.org/10.3345/kjp.2015.58.11.440
11. Selbst SM, Ruddy RM, Clark BJ, Henretig FM, Santulli T Jr. Pediatric chest pain: a prospective study. Pediatrics. 1988 Sep;82(3):319-23.
12. Evangelista JA, Parsons M, Renneburg AK. Chest pain in children: diagnosis through history and physical examination. J Pediatr Health Care. 2000 Jan-Feb;14(1):3-8. https://doi.org/10.1016/s0891-5245(00)70037-x
13. Drossner DM, Hirsh DA, Sturm JJ, Mahle WT, Goo DJ, Massey R, et al. Cardiac disease in pediatric patients presenting to a pediatric ED with chest pain. Am J Emerg Med. 2011 Jul;29(6):632-8. https://doi.org/10.1016/j.ajem.2010.01.011
14. Swenson JM, Fischer DR, Miller SA, Boyle GJ, Ettedgui JA, Beerman LB. Are chest radiographs and electrocardiograms still valuable in evaluating new pediatric patients with heart murmurs or chest pain? Pediatrics. 1997 Jan;99(1):1-3. https://doi.org/10.1542/peds.99.1.1
15. Horton LA, Mosee S, Brenner J. Use of the electrocardiogram in a pediatric emergency department. Arch Pediatr Adolesc Med. 1994 Feb;148(2):184-8. https://doi.org/10.1001/archpedi.1994.02170020070012