Myocardial Damage Presented with Abdominal Pain in 33 Children / 实用儿科临床杂志

ABSTRACT

Objective To investigate the clinical characteristics,treatment and prognosis of myocardial damage presented with abdominal pain in children.Methods The clinical data of 33 children with myocardial damage presented with abdominal pain in Beijing Anzhen Hospital during the past 4 years were analyzed.Emergency conditions were ruled out in all cases.Results Among 33 cases with myocardial damage presented with abdominal pain,there were 10 cases of pneumonia,9 cases of acute bronchitis,7 cases of upper respiratory tract infection,1 case of allergic purpura,1 case of myocarditis and 5 cases of unknown causes.The duration of abdominal pain lasted 2 days to 3 months.The characteristics and the duration of abdominal pain were irregular.Mycoplasma antibodies positive were 5 cases (2 cases of bronchitis,3 cases of pneumonia).Coxvirus antibodies were 2 cases.There were different symptoms and signs of myocardial damage.Holterthere were ST-T changes in 23 children and 17 frequent premature ventricular complex(pattern of bigeminy and trigeminy in 7 children,premature atrial complex in 4 children).Creatine kinase isoenzyme-MB were high in 21 children(30-124 U?L-1).Cardiac troponin I were high in 19 children(0.8-1.2 ng?L-1).Chest X-raycardiomegaly was noted in 7 children,and the ratio of cardiac and chest were 0.55-0.58.Echocardiographythe left ventricular end-diastolic diameter was enlarged in 5 children,the right atrium was enlarged in 1 child.Most abdominal pain was relieved with treatment in 5 to 7 days,and 14 days was the longest.Total treatment course was 2 weeks to 1 month,and 3 months was the longest.But 1 case with myocarditis was recurrent abdominal pain treated nearly 3 months,and lasted to 6 months for recovery.Conclusions It is important to pay attention to cardial examination early,when a child becomes inconsolable from abdominal pain but emergency conditions should be ruled out.