Electrocardiograms in school-aged healthy Polish children - an observational study.

BACKGROUND: Electrocardiographic (ECG) examination has long been used to assess cardiovascular function in clinical practice. Age-related ECG changes are observed as the cardiovascular system matures from the neonatal period to adolescence. AIM: This study aimed to evaluate effects of sex and age on ECG parameters in healthy schoolchildren. METHODS: The study included 336 healthy participants aged 5-12 years from the Masovian voivodeship. Children were divided into age groups of 5-8 and 9-12 years. Values for heart rate (HR), time intervals and amplitudes of P and QRS waves, and QRS axis for pediatric ECGs were estimated. RESULTS: Significant differences between boys and girls aged 5-8 years old were discovered for such parameters as PR interval, R-wave, S-wave, and the R/S ratio. Age-related decline in HR, Q-wave in V5 and V6, R-wave in V1-V4, and increase in QRS duration were noted. Girls presented a higher HR and shorter QRS than boys. HR, QRS axis, P wave amplitude in lead II, and amplitude of R and S in the precordial leads were different in our population than those previously reported. CONCLUSIONS: Pediatric ECG tracings were estimated for the first time for healthy Polish schoolchildren. Sex-related differences in selected ECG parameters in the younger age group were noticed. Several parameters differed from those previously reported in other ethnic populations. These findings are clinically significant and suggest that diagnostic criteria for pediatric ECG should be revised to establish if they are justifiable for the entire population.

Normative Values for Heart Rate Variability Parameters in School-Aged Children: Simple Approach Considering Differences in Average Heart Rate.

Background: Heart rate variability (HRV) analysis is a clinical tool frequently used to characterize cardiac autonomic status. The aim of this study was to establish normative values for short-term HRV parameters by considering their main determinants in school-aged children. Methods: Five-minute electrocardiograms were taken from 312 non-athlete children (153 boys) at age of 6 to 13 years for computation of conventional time- and frequency-domain HRV parameters. Heart rate (HR), respiratory rate, age, body mass index, and sex were considered as their potential determinants. Multiple regression analysis revealed that HR was the principal predictor of all standard HRV indices. To develop their universal normative limits, standard HRV parameters were corrected for prevailing HR. Results: The HRV correction for HR yielded the parameters which became independent on both sex and HR, and only poorly dependent on age (with small effect size). Normal ranges were calculated for both time- and frequency-domain indices (the latter computed with either fast Fourier transform and autoregressive method). To facilitate recalculation of standard HRV parameters into corrected ones, a calculator was created and attached as a Supplementary Material that can be downloaded and used for both research and clinical purposes. Conclusion: This study provides HRV normative values for school-aged children which have been developed independently of their major determinants. The calculator accessible in the Supplementary Material can considerably simplify determination if HRV parameters accommodate within normal limits.

Bland-White-Garland syndrome - a rare and serious cause of failure to thrive.

PATIENT: Male, 0 FINAL DIAGNOSIS: Bland-White-Garland syndrome Symptoms: Cardiomegaly, feeding problems Medication: - Clinical Procedure: Reimplantation of the left coronary artery to the aorta Specialty: Pediatrics and Neonatology. OBJECTIVE: Rare disease. BACKGROUND: Bland-White-Garland syndrome (BWGS) is a very rare disease characterized by anomalous origin of the left coronary artery from the pulmonary trunk (ALCAPA). WBGS affects 1 in every 300 000 live births. Children typically present with dyspnea, pallor, and failure to thrive. Without surgical repair, most of these children die during the first months of life. CASE REPORT: This case report describes 3-month-old boy admitted to the hospital because of feeding problems. The boy was born at term, with birth weight 3200 g, and was 10 points in Apgar score. He was breast-fed from birth. From the seventh week of age, his mother observed his increasing difficulties with feeding. Physical examination revealed pale skin, diminished heart sounds, tachycardia, cardiomegaly, and hepatomegaly. Results of urine and blood tests and ultrasonography of the central nervous system and abdomen were normal. The chest radiography showed cardiomegaly and electrocardiogram revealed anterolateral myocardial infarction. On echocardiography, an anomalous left coronary artery arising from the pulmonary artery was found. The life-saving treatment of choice was immediate surgical reimplantation of the left coronary artery to the aorta. CONCLUSIONS: Children with congenital heart disease are often prone to malnutrition, but in rare cases failure to thrive and breast-feeding problems can be the first symptoms of life-threatening diseases like myocardial infarction secondary to Bland-White-Garland syndrome (BWGS).

[Parainfluenza type 3 virus infection in neonates with cardiac arrhythmia]. / Zakazenie wirusem paragrypy typu 3 u noworodków z zaburzeniami rytmu.

The aim of the study was to assess the frequency of the occurrence of parainfluenza type 3 virus infection in neonates with cardiac arrhythmia. In 12 (17%) out of 70 of neonates parainfluenza type 3 virus infection was recognized basing on serologic hemagglutinin inhibition test. Ten of them were diagnosed with mild course of myocarditis. Among 12 neonates infected with parainfluenza type 3 virus supraventricular and ventricular arrhythmia was observed in 5 and mild periodical bradycardia was diagnosed. None of the neonates were treated with antiarrhythmic medications. The authors would like to point out that interpretation of the serologic tests in neonates are difficult.