ABSTRACT
Objective: To determine the age range, where juvenile T inversion pattern in right precordial leads (V1 to V4) in an ECG changes to the adult upright T wave pattern Method: A descriptive cross-sectional study was done in children aged 5 years and above referred to the paediatric cardiology clinic, Teaching Hospital Karapitiya from January 2012 to April 2013. Inclusion criteria were: children with no cardiac lesion or a haemodynamically insignificant cardiac lesion after a full cardiac evaluation.The cohort was divided into six age groups and the presence of juvenile and adult ECG patterns were evaluated. Results: A total number of 1039 children were enrolled. At the age of 13 years 50% depicted both juvenile and adult ECG patterns. At the age range of 13-15 years 78 (60%) of a total of 130 showed the adult ECG pattern compared to 99 (44.4%) of a total of 223 at 11-13 years (X2=8.0; p=0.005). Even after 13 years of age the juvenile ECG pattern persisted in 30-40% of children. Conclusions: Transition of the juvenile T inversion pattern in right precordial leads in an ECG to the adult upright T wave pattern occurs predominantly at the age range of 13-15 years. Presence of juvenile T inversion pattern in an ECG after 13-15 years can be a normal finding as well as may be a pre-symptomatic diagnosis of a cardiomyopathy. Although it is normal to have a juvenile ECG pattern above 13 years it is advisable to perform an echocardiographic evaluation on children above 13 years with juvenile T inversion pattern which may lead to early diagnosis of cardiomyopathy.
ABSTRACT
Objective: To determine the outcome of children referred to the paediatric cardiology unit with a previous echocardiographic diagnosis of mitral valve prolapse (MVP). Method: This study was carried out at the paediatric cardiology clinic of Teaching Hospital Karapitiya from 1st January 2012 to 31st December 2012. All children (18 years or less) presenting with a previous echocardiographic diagnosis of MVP were included in study. An echocardiographic diagnosis of MVP was reached based on the standard diagnostic criteria using an IE 33 Phillips echocardiography machine. Results: There were 141 children presenting with a previous echocardiographic diagnosis of MVP of whom 50.4% were male. Seventeen percent were below 5 years, 45% 5-9 years, 36% 10-14 years and 2% above 14 years. Of the 141, 53.2% did not have a cardiac murmur, 41.8% had a grade 2 cardiac murmur and 5% had a grade 3 murmur. Only 7 (5%) were confirmed to have MVP using standard diagnostic criteria. Of these 7 cases, 3 did not have a murmur and the remaining 4 had a grade 3 murmur best heard in the mitral area. Out of 141 subjects 57.5% had undergone 2 previous echocardiographic evaluations and 40.4% had 3-6 previous echocardiographic evaluations. Conclusion: This study shows gross over diagnosis of MVP when the standard diagnostic criteria to diagnose MVP are applied.