The Effect of Axis Values on Electrocardiography in Prediction of Congenital Heart Diseases in Children without a Known History of Heart Disease

Abstract

Aim: In this study,the predictive value of electrocardiography(ECG) axis measurements at diagnosis of congenital heart diseases(CHD) were evaluated in children.Materials and Methods: The children between 1 month and 16 years of age without a known history of CHD who applied to pediatric cardiology outpatient clinic were included in the study.Pathology at physical examination,P,QRS,T axis and QRS-T angle values and the diagnosis of a CHD at echocardiography were evaluated.Results were evaluated statistically.Results: Two hundred and sixty cases were evaluated during the study period.Median age was 24 months(1-160months).The 45% of the patients were evaluated as normal at cardiovascular system examination.Murmur was present in 40% of the patients and other pathologic findings additionally to the murmur were found in another 15% of the patients.ECG evaluations revealed abnormal P axis in 5 patients,left axis deviation in 23 patients,right axis deviation in 29 patients, superior axis in 3 patients,abnormal T axis in 18 patients and pathologic QRS-T angle in 32 patients.Echocardiographic stuies revealed CHD at 68 patients.The pathology at physical examination did not effect the ECG axis values and the abnormal changes at QRS-T angle(p>0.05)but signicantly increasing the frequency of CHD diagnosis at echocardiography(p<0.05).The presence of CHD was not found different in terms of P,QRS and T axis.Congenital heart disease was found significantly higher in patients especially with left axis deviation,QRS-T angle pathology and abnormal T axis(p<0.05).Conclusion: Children with pathological auscultation findings at the cardiovascular system examination, left axis deviation or pathological QRS-T angle at ECG should be evaluated by transthoracic echocardiography.

Keywords

• child
• electrocardiography
• congenital
• heart diseases