Patterns of Electrocardiographic Abnormalities in Children with Hypertrophic Cardiomyopathy.

Document Type

Article

Publication Date

12-2024

Identifier

DOI: 10.1007/s00246-023-03252-4

Abstract

Hypertrophic cardiomyopathy (HCM), a common cardiomyopathy in children, is an important cause of morbidity and mortality. Early recognition and appropriate management are important. An electrocardiogram (ECG) is often used as a screening tool in children to detect heart disease. The ECG patterns in children with HCM are not well described.ECGs collected from an international cohort of children, and adolescents (≤ 21 years) with HCM were reviewed. 482 ECGs met inclusion criteria. Age ranged from 1 day to 21 years, median 13 years. Of the 482 ECGs, 57 (12%) were normal. The most common abnormalities noted were left ventricular hypertrophy (LVH) in 108/482 (22%) and biventricular hypertrophy (BVH) in 116/482 (24%) Of the patients with LVH/BVH (n = 224), 135 (60%) also had a strain pattern (LVH in 83, BVH in 52). Isolated strain pattern (in the absence of criteria for hypertrophy) was seen in 43/482 (9%). Isolated pathologic Q waves were seen in 71/482 (15%). Pediatric HCM, 88% have an abnormal ECG. The most common ECG abnormalities were LVH or BVH with or without strain. Strain pattern without hypertrophy and a pathologic Q wave were present in a significant proportion (24%) of patients. Thus, a significant number of children with HCM have ECG abnormalities that are not typical for "hypertrophy". The presence of the ECG abnormalities described above in a child should prompt further examination with an echocardiogram to rule out HCM.

Journal Title

Pediatric cardiology

Volume

45

Issue

8

First Page

1692

Last Page

1701

MeSH Keywords

Humans; Electrocardiography; Child; Cardiomyopathy, Hypertrophic; Adolescent; Male; Female; Child, Preschool; Infant; Hypertrophy, Left Ventricular; Infant, Newborn; Young Adult; Retrospective Studies

Keywords

Electrocardiogram; Hypertrophic cardiomyopathy; Left ventricular hypertrophy; Pediatric; Strain; Sudden death

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