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Articles

Title: Evaluation of the cardiovascular system in children with connective tissue diseases

Author:
Katarzyna Niewiadomska-Jarosik, Anna Rykała, Elżbieta Smolewska, Małgorzata Biernacka-Zielińska, Henryka Brózik, Justyna Marciszewska, Jerzy Stańczyk
Type:
Original articles
Language:
PL
Journal:
Pediatric Review
Year:
2005
Volume:
35
Number:
1
Start page:
28
Final page:
32
ISSN:
0137-723X
Keywords:
connective tissue diseases, children, cardiovascular system, echocardiography, ECG, Holter ECG
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Introduction. Lesions in the systemic connective tissue diseases involve not only the motor system, but also internal organs including whole structures of the cardiovascular system. Pathological lesions in the circulatory system are frequently undetected due to lack ofclinical symptoms or pathologic changes on physical examination and hence are known as "silent heart diseases". Therefore, early cardiological diagnosis is ofgreat importance. Material and methods. Cardiac involvement in collagen diseases was studied in 50 children, out ofwhom 44 had recognisedjuvenile idiopathic arthritis, 6 - systemic lupus erytematosus. The control group comprised 32 healthy children. Diagnostics of the cardiovascular system consisted of: physical examination, ECG, Holter ECG and echocardiographic examination. Results. Abnormalities on physical examination were observed in 20 children from the study group and 6 in control group. Changes in ECG were found in 16 patients with collagen diseases: 13% had tachycardia, 7.4% incomplete right bundle branch block, 5.6% extrasystole and 3.4% atrio-ventricular block offirst degree. According to Holter ECG a notable acceleration of the sinus rhythm and more frequent presence of arrhythmia were observed in children with collagen diseases. Abnormalities on echocardiographic examination were detected in 33 children with collagen diseases (61.1%). They included: valvular insufficiency, fluid in the pericardium and contractility disturbances. Conclusions. Echocardiographic examination seems to be the most effective in monitoring the condition of cardiovascular system in children with connective tissue diseases and the best in showing mute clinical changes. Evaluation ofthe circulatory system in children with collagen diseases should be a routine procedure.