Does the electrocardiogram grow with an adolescent?: a 3-year follow-up study

Background: Human heart’s growth and development are followed by gradual changes on the electrocardiogram. The study was conducted to analyse changes in the resting electrocardiogram of 10-year-olds in relation to their somatic growth. Methods: 120 students (62 male) aged 10.8 (+/-0.49) years were examined. The study consisted of a resting electrocardiogram and anthropometric measurements repeated in 3-year interval. Statistical analysis of changes in electrocardiographic parameters (PR, QRS, QTc, QRS axis, wave amplitudes) and corresponding changes in height, weight and BMI was conducted. Results: Through time, a substantial elongation of PR (p &lt; 0.001), ORS (p &lt; 0.001) and QT (p &lt; 0.001) lengths was observed while the QRS axis and corrected QT time remained stable (p=0.320 and 0.857 respectively). In girls PR elongation correlated with an increase in BMI (r=0.33). Right axis deviation corresponded with height gain in boys (r=0.45). R and S amplitudes in limb leads did not change significantly except for lead I. There was a considerable decline in R and S wave voltages in precordial leads in adolescent girls that corresponded with weight and BMI increase. In boys the increase in BMI was related to greater R waves in left precordial leads. Conclusion: Adolescent growth has an influence on some electrocardiographic variables. There are significant differences between boys’ and girls’ electrocardiograms regarding QRS amplitudes.Background: Human heart’s growth and development are followed by gradual changes on the electrocardiogram. The study was conducted to analyse changes in the resting electrocardiogram of 10-year-olds in relation to their somatic growth. Methods: 120 students (62 male) aged 10.8 (+/-0.49) years were examined. The study consisted of a resting electrocardiogram and anthropometric measurements repeated in 3-year interval. Statistical analysis of changes in electrocardiographic parameters (PR, QRS, QTc, QRS axis, wave amplitudes) and corresponding changes in height, weight and BMI was conducted. Results: Through time, a substantial elongation of PR (p < 0.001), ORS (p < 0.001) and QT (p < 0.001) lengths was observed while the QRS axis and corrected QT time remained stable (p=0.320 and 0.857 respectively). In girls PR elongation correlated with an increase in BMI (r=0.33). Right axis deviation corresponded with height gain in boys (r=0.45). R and S amplitudes in limb leads did not change significantly except for lead I. There was a considerable decline in R and S wave voltages in precordial leads in adolescent girls that corresponded with weight and BMI increase. In boys the increase in BMI was related to greater R waves in left precordial leads. Conclusion: Adolescent growth has an influence on some electrocardiographic variables. There are significant differences between boys’ and girls’ electrocardiograms regarding QRS amplitudes

Case Report: Unexplained Fever and Chest Pain in a 5-Year-Old

Pericarditis is a rare, but severe cause of chest pain in children that can easily be overlooked during routine diagnostics. Fibrinous pericarditis was recognized in a 5-year old patient who presented with fever and chest pain. Despite thorough diagnostics, no evident etiological factor was found. Furthermore, the disease was unresponsive to broad-spectrum antibiotics and NSAIDs, however oral prednisone was found to cause rapid improvement in the patients' condition. It was presumed that the patient's condition was caused by a blunt trauma to the chest experienced 3 days prior to the onset of symptoms. In an 8-month follow-up the patient remains in good overall condition and no recurrences were observed

Anthropometric Determinants of Respiratory Sinus Arrhythmia in Children

Background: The study was conducted to investigate the implications of anthropometry in school-aged children on the degree of respiratory sinus arrhythmia observed in clinical settings. Methods: In a cohort study, 626 healthy children (52% male) aged 10.8 &plusmn; 0.5 years attending primary school in a single town underwent a 12-lead electrocardiogram coupled with measurements of height, weight and blood pressure. Indices of respiratory sinus arrhythmia (pvRSA, RMSSD, RMSSDc) were derived from semi-automatic measurements of RR intervals. Height, weight, BMI, blood pressure as well as waist and hip circumferences were compared between subjects with rhythmic heart rate and respiratory sinus arrhythmia, and correlations between indices of sinus arrhythmia and anthropometry were investigated. Results: Respiratory sinus arrhythmia was recognized in 43% of the participants. Subjects with sinus arrhythmia had lower heart rate (p &lt; 0.001), weight (p = 0.009), BMI (p = 0.005) and systolic (p = 0.018) and diastolic (p = 0.004) blood pressure. There were important inverse correlations of heart rate and indices of sinus arrhythmia (r = &minus;0.52 for pvRSA and r = &minus;0.58 for RMSSD), but not the anthropometry. Conclusion: Lower prevalence of respiratory sinus arrhythmia among children with overweight and obesity is a result of higher resting heart rate observed in this population