RESUMEN
OBJECTIVES: Athletes performing sports on high level are at increased risk for sudden cardiac death. This includes paediatric athletes, even though data on screening strategies in this age group remain scarce. This study aimed to assess electrocardiogram interpretation criteria in paediatric athletes and to evaluate the cost of screening. METHODS: National, multicentre, retrospective, observational study on 891 athletes of paediatric age (<18â¯years) evaluated by history, physical examination and 12-lead electrocardiogram. The primary outcome measure was abnormal electrocardiogram findings according to the International Recommendations for Electrographic Interpretation in Athletes. The secondary outcome measure was cost of screening. RESULTS: 19 athletes (2.1%) presented abnormal electrocardiogram findings requiring further investigations, mainly abnormal T-wave inversion. These 19 athletes were predominantly males, performing endurance sports with a mean volume of 10 weekly hours for a mean duration of 6â¯years of training. Further investigations did not identify any relevant pathology. All athletes were cleared for competition with regular follow-up. Total costs of the screening were 108,860 USD (122 USD per athlete). CONCLUSIONS: Our study using the International Recommendations for Electrographic Interpretation in Athletes identified a low count of abnormal findings in paediatric athletes, yet raising substantially the cost of screening. Hence, the utility of electrocardiogram-inclusive screening of paediatric athletes remains to be elucidated by longitudinal data.
Asunto(s)
Cardiopatías , Adolescente , Atletas , Niño , Costos y Análisis de Costo , Muerte Súbita Cardíaca/prevención & control , Electrocardiografía , Cardiopatías/diagnóstico , Humanos , Masculino , Estudios Retrospectivos , SuizaAsunto(s)
Bronquiolitis/complicaciones , Hiponatremia/etiología , Encefalopatías/diagnóstico , Encefalopatías/etiología , Bronquiolitis/sangre , Bronquiolitis/diagnóstico , Bronquiolitis/terapia , Cloruros/sangre , Enfermedades en Gemelos/sangre , Enfermedades en Gemelos/diagnóstico , Enfermedades en Gemelos/etiología , Enfermedades en Gemelos/terapia , Femenino , Humanos , Hiponatremia/sangre , Hiponatremia/diagnóstico , Hiponatremia/terapia , Lactante , Enfermedades del Prematuro/sangre , Enfermedades del Prematuro/diagnóstico , Enfermedades del Prematuro/etiología , Enfermedades del Prematuro/terapia , Unidades de Cuidado Intensivo Pediátrico , Examen Neurológico , Admisión del Paciente , Factores de Riesgo , Convulsiones/sangre , Convulsiones/diagnóstico , Convulsiones/etiología , Convulsiones/terapia , Sodio/sangreRESUMEN
Antiphospholipid Syndrome (APS) describes a systemic disease caused by autoantibodies to membrane components. Involving coagulation pathways, complement factors and immune cells, it results in thrombosis in any blood vessel. Its clinical presentation varies considerably depending upon the organ affected. Paediatric data on APS remain sparse. Most case reports focus on catastrophic APS with multiple small-vessel occlusions and a life-threatening course. Here, we report on a 15-year-old patient with deep vein thrombosis and a right ventricular tumour posing the risk of a fulminant pulmonary embolism. The tumour was surgically removed. Histology revealed it to be a thrombus. The patient fully recovered and is currently treated with long term anticoagulation.