Patterns of Electrocardiographic Abnormalities in Children with Hypertrophic Cardiomyopathy

Mayme Marshall; Aneeq Malik; Maully Shah; Frank A. Fish; Susan P. Etheridge; Peter F. Aziz; Mark W. Russell; Svjetlana Tisma; Andreas Pflaumer; Narayanswami Sreeram; Peter Kubus; Ian H. Law; Michal J. Kantoch; Naomi J. Kertesz; Margaret Strieper; Christopher C. Erickson; Jeremy P. Moore; Stephanie J. Nakano; Harinder R. Singh; Philip Chang; Mitchell Cohen; Anne Fournier; Maria V. Ilina; Frank Zimmermann; Michaela Horndasch; Walter Li; Anjan S. Batra; Leonardo Liberman; Robert Hamilton; Christopher M. Janson; Shubhayan Sanatani; Ilana Zeltser; George McDaniel; Andrew D. Blaufox; Jason M. Garnreiter; Seshadri Balaji

doi:10.1007/s00246-023-03252-4

Patterns of Electrocardiographic Abnormalities in Children with Hypertrophic Cardiomyopathy

Mayme Marshall, Aneeq Malik, Maully Shah, Frank A. Fish, Susan P. Etheridge, Peter F. Aziz, Mark W. Russell, Svjetlana Tisma, Andreas Pflaumer, Narayanswami Sreeram, Peter Kubus, Ian H. Law, Michal J. Kantoch, Naomi J. Kertesz, Margaret Strieper, Christopher C. Erickson, Jeremy P. Moore, Stephanie J. Nakano, Harinder R. Singh, Philip ChangMitchell Cohen, Anne Fournier, Maria V. Ilina, Frank Zimmermann, Michaela Horndasch, Walter Li, Anjan S. Batra, Leonardo Liberman, Robert Hamilton, Christopher M. Janson, Shubhayan Sanatani, Ilana Zeltser, George McDaniel, Andrew D. Blaufox, Jason M. Garnreiter, Seshadri Balaji

Pediatrics

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

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.

Original language	English (US)
Journal	Pediatric Cardiology
DOIs	https://doi.org/10.1007/s00246-023-03252-4
State	Accepted/In press - 2023

Keywords

Electrocardiogram
Hypertrophic cardiomyopathy
Left ventricular hypertrophy
Pediatric
Strain
Sudden death

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Cardiology and Cardiovascular Medicine

Access to Document

10.1007/s00246-023-03252-4

Cite this

Marshall, M., Malik, A., Shah, M., Fish, F. A., Etheridge, S. P., Aziz, P. F., Russell, M. W., Tisma, S., Pflaumer, A., Sreeram, N., Kubus, P., Law, I. H., Kantoch, M. J., Kertesz, N. J., Strieper, M., Erickson, C. C., Moore, J. P., Nakano, S. J., Singh, H. R., ... Balaji, S. (Accepted/In press). Patterns of Electrocardiographic Abnormalities in Children with Hypertrophic Cardiomyopathy. Pediatric Cardiology. https://doi.org/10.1007/s00246-023-03252-4

Marshall, M, Malik, A, Shah, M, Fish, FA, Etheridge, SP, Aziz, PF, Russell, MW, Tisma, S, Pflaumer, A, Sreeram, N, Kubus, P, Law, IH, Kantoch, MJ, Kertesz, NJ, Strieper, M, Erickson, CC, Moore, JP, Nakano, SJ, Singh, HR, Chang, P, Cohen, M, Fournier, A, Ilina, MV, Zimmermann, F, Horndasch, M, Li, W, Batra, AS, Liberman, L, Hamilton, R, Janson, CM, Sanatani, S, Zeltser, I, McDaniel, G, Blaufox, AD, Garnreiter, JM & Balaji, S 2023, 'Patterns of Electrocardiographic Abnormalities in Children with Hypertrophic Cardiomyopathy', Pediatric Cardiology. https://doi.org/10.1007/s00246-023-03252-4

@article{462b151f07fb49079911443e719a895e,

title = "Patterns of Electrocardiographic Abnormalities in Children with Hypertrophic Cardiomyopathy",

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.",

keywords = "Electrocardiogram, Hypertrophic cardiomyopathy, Left ventricular hypertrophy, Pediatric, Strain, Sudden death",

author = "Mayme Marshall and Aneeq Malik and Maully Shah and Fish, {Frank A.} and Etheridge, {Susan P.} and Aziz, {Peter F.} and Russell, {Mark W.} and Svjetlana Tisma and Andreas Pflaumer and Narayanswami Sreeram and Peter Kubus and Law, {Ian H.} and Kantoch, {Michal J.} and Kertesz, {Naomi J.} and Margaret Strieper and Erickson, {Christopher C.} and Moore, {Jeremy P.} and Nakano, {Stephanie J.} and Singh, {Harinder R.} and Philip Chang and Mitchell Cohen and Anne Fournier and Ilina, {Maria V.} and Frank Zimmermann and Michaela Horndasch and Walter Li and Batra, {Anjan S.} and Leonardo Liberman and Robert Hamilton and Janson, {Christopher M.} and Shubhayan Sanatani and Ilana Zeltser and George McDaniel and Blaufox, {Andrew D.} and Garnreiter, {Jason M.} and Seshadri Balaji",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2023",

doi = "10.1007/s00246-023-03252-4",

language = "English (US)",

journal = "Pediatric Cardiology",

issn = "0172-0643",

publisher = "Springer New York",

}

TY - JOUR

T1 - Patterns of Electrocardiographic Abnormalities in Children with Hypertrophic Cardiomyopathy

AU - Marshall, Mayme

AU - Malik, Aneeq

AU - Shah, Maully

AU - Fish, Frank A.

AU - Etheridge, Susan P.

AU - Aziz, Peter F.

AU - Russell, Mark W.

AU - Tisma, Svjetlana

AU - Pflaumer, Andreas

AU - Sreeram, Narayanswami

AU - Kubus, Peter

AU - Law, Ian H.

AU - Kantoch, Michal J.

AU - Kertesz, Naomi J.

AU - Strieper, Margaret

AU - Erickson, Christopher C.

AU - Moore, Jeremy P.

AU - Nakano, Stephanie J.

AU - Singh, Harinder R.

AU - Chang, Philip

AU - Cohen, Mitchell

AU - Fournier, Anne

AU - Ilina, Maria V.

AU - Zimmermann, Frank

AU - Horndasch, Michaela

AU - Li, Walter

AU - Batra, Anjan S.

AU - Liberman, Leonardo

AU - Hamilton, Robert

AU - Janson, Christopher M.

AU - Sanatani, Shubhayan

AU - Zeltser, Ilana

AU - McDaniel, George

AU - Blaufox, Andrew D.

AU - Garnreiter, Jason M.

AU - Balaji, Seshadri

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - Electrocardiogram

KW - Hypertrophic cardiomyopathy

KW - Left ventricular hypertrophy

KW - Pediatric

KW - Strain

KW - Sudden death

UR - http://www.scopus.com/inward/record.url?scp=85170092257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85170092257&partnerID=8YFLogxK

U2 - 10.1007/s00246-023-03252-4

DO - 10.1007/s00246-023-03252-4

M3 - Article

AN - SCOPUS:85170092257

SN - 0172-0643

JO - Pediatric Cardiology

JF - Pediatric Cardiology

ER -

Patterns of Electrocardiographic Abnormalities in Children with Hypertrophic Cardiomyopathy

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this