Early repolarization of the ventricles of the heart in children

Recently, early ventricular repolarization syndrome (ATS) is very common – 8% of completely healthy men, women and children during routine examinations learn about this ECG phenomenon. The risk group includes:

  • patients with pathologies with the heart, which are accompanied by interruptions in work;
  • people who are actively involved in sports;
  • black men;
  • patients with dysplastic collagenosis.

Most patients ask what the ventricular early repolarization syndrome means. It represents an uncharacteristic change in the curve of the electrocardiogram and may be permanent or transient. Very often, the ECG phenomenon occurs in adolescents and children. There are 3 species that have common features, but differ in severity:

  • maximum – has more than 6 leads;
  • moderate – consists of 4-5 leads;
  • minimal – characterized by 2-3 leads.

Syndrome of early repolarization of the ventricles occurs not only in patients who have acquired or congenital pathologies with the heart, but also in those who have:

  • hypertrophic cardiomyopathy;
  • connective tissue dysplasia (spider fingers, joint hypermobility, prolapse in the mitral canal);
  • familial hyperlipidemia;
  • cardiovascular diseases;
  • neurocircular dystonia;
  • genetic predisposition.

During a series of studies, scientists proved that the ECG phenomenon of early ventricular repolarization can lead to sudden coronary death if accompanied by episodic syncope of cardiac origin. The syndrome often contributes to the development of diseases such as:

  • heart failure;
  • supraventricular arrhythmia;
  • sinus tachycardia and bradycardia;
  • heart ischemia;
  • atrial fibrillation;
  • paroxysmal tachycardia;
  • hemodynamic impairment;
  • vascular damage of the heart, etc.

If, after an electrocardiogram, you encounter a problem such as early ventricular repolarization syndrome in children, then you need to know that you will need to be fully examined to confirm the diagnosis of the child. To do this, doctors suggest taking detailed blood tests (from the finger and vein) and urine, as well as making an ultrasound scan of the heart several times. The frequency depends on the patient’s health status.

This diagnosis in childhood is not a sentence. The examination is carried out in order to exclude disturbances in the work of the heart and its rhythm. Are there any pathologies in the main muscle of a person, only a cardiologist can determine. He appoints a regular examination of the child with an interval of several months. There is a syndrome in those children who had problems with blood circulation in the womb.

If your child is diagnosed with ventricular early repolarization syndrome, then in the future you will need to:

  1. Reduce physical activity and reduce their intensity.
  2. Protect the child from all kinds of stress.
  3. Observe diet.
  4. Ensure that the child leads a healthy lifestyle.

Most of all, teenagers are affected by this condition. This is especially evident during puberty. Elements of the ventricular early repolarization syndrome are small changes in the functioning of the heart. Children should undergo a comprehensive examination, which, in addition to tests, includes ECHO-KG and ECG. If pathologies are not identified, then treatment is not prescribed. Doctors recommend to parents:

  1. Check the child every six months.
  2. Giving vitamins to children.
  3. Make sure that the child leads a calm lifestyle (without stress and strong physical exertion).
  4. Feed your children healthy and varied foods.

During the studies, which consisted of monitoring professional athletes, it was found that about 80% of them have bradycardia (heart rate in 1 minutes reaches 60). Syndrome of early repolarization of the ventricles of the heart is manifested in the predominance of vagal influence and the development of adaptive thickening of the wall in the left ventricle. Such people should:

  1. Reduce the load.
  2. Exclude the constant use of drugs (doping).
  3. Observe a doctor.

When the expectant mother is diagnosed with the syndrome of early repolarization of the ventricular myocardium, she begins to panic, she is very worried and the question arises of how this situation will affect the baby and the process of bearing. Scientists have proved that the ECG phenomenon does not affect the development and health of the fetus if the pregnant woman has no other serious diseases (for example, arrhythmias).

The repolarization process is very important for the body, because as a result of it, the heart is prepared for systole, and normal excitability of the muscles of the organ is also ensured. In addition, the duration and quality of organ relaxation is reflected in the phase of its contraction.

During normal heart function, both phases of its contraction proceed in strict sequence:

  1. First, the process of depolarization starts in the interventricular septum.
  2. After that, it spreads to the left and right ventricles, followed by the stage of relaxation.

What is the danger of early ventricular repolarization syndrome of the heart? Despite the fact that with this deviation no complaints of patients are observed, its symptoms do not belong to the normal functioning of the body. To date, it has already been precisely proven that the syndrome of early repolarization of the heart is able to create a soil favorable for the development of myocardial infarction. Doctors also note a difficult diagnosis of dystrophic changes and hypertrophy with this deviation.

In many patients, ATS was detected against the background of the following disorders:

  • bouts of atrial fibrillation;
  • paroxysmal supraventricular tachycardia;
  • extrasystole.

The danger of the disease occurs if an attack of flicker causes ventricular fibrillation. This often ends in the death of the patient.

What is the danger of ventricular repolarization syndrome

The phenomenon of early ventricular repolarization has long been considered one of the normal options. Over time, it turned out that a constant form of this pathology can provoke the development of arrhythmia, myocardial hypertrophy, and other complications, and cause sudden coronary death. Therefore, if characteristic changes are detected on the ECG, an examination is required to detect or rule out more serious diseases of the cardiovascular system.

Causes and risk factors

The main causes of this pathology are as follows:

  • neuroendocrine ailments, which are most often manifested in childhood;
  • hypercholesterolemia in the blood;
  • increased physical activity;
  • heart defects, both congenital and acquired, as well as disorders in the structure of the conducting system;
  • changes that are observed in systemic diseases that relate to connective tissue;
  • hypertrophic cardiomyopathy;
  • impulse movement in roundabout ways.

The following people are at risk of developing this pathology:

  • professional athletes;
  • adolescents whose puberty is too active;
  • children with congenital heart defects and various developmental pathologies.

Diagnostic measures

As already mentioned above, this disease can be detected only by means of an ECG. On an electrocardiogram, pathology is defined as follows:

  1. The ST interval is shifted up. Normally, a smooth transition to the ascending segment of the T wave is observed. If there is a sharp rise in this place, this indicates the development of necrosis, intoxication and severe dystrophy. The appearance of pericarditis is also possible. In the presence of accelerated repolarization, an interval increase of more than 3 mm is observed.
  2. The presence of a characteristic “notch” in the department R.
  3. An increase in the T wave in the presence of its wide base. This pathology may be similar to the development of diseases such as coronary disease and hyperkalemia.

Diagnostics

Due to the asymptomatic development of the premature repolarization syndrome, it is detected by chance, as a result of being examined on an electrocardiograph. If characteristic changes in the readings are detected, tests such as:

  • Registration of an ECG under additional physical activity.
  • For the expressiveness of the manifestation of signs, a test using potassium or procainamide.
  • Daily ECG monitoring.
  • Lipidogram.
  • Blood chemistry.

In the process of diagnosis, the disease must be differentiated with pericarditis, hyperkalemia, Brugada syndrome, electrolyte imbalance, arrhythmogenic dysplasia in the right ventricle. After the consultation, the cardiologist prescribes a comprehensive examination, which necessarily includes echocardiography (ultrasound of the heart) and cardioangiography.

Course of therapy

If the syndrome has an uncomplicated course, then specific treatment is not carried out. In this case, the patient must adhere to the following recommendations:

  • abandon excessive physical exertion;
  • eat correctly and balanced, reducing the consumption of animal fats and increasing the number of fruits and vegetables in the diet;
  • normalize sleep, eliminate stressful situations.

If the changes are neglected, then their treatment is carried out, suggesting the following medications:

  • for cardiac pathologies, specific agents are used, such as antihypertensive drugs, coronarolytics, etc.
  • as coenzymes, B vitamins can be used that restore the normal process of impulse transmission;
  • anti-arrhythmias, which help slow down the processes of repolarization, which is why rhythm disturbances occur;
  • specialists can also prescribe drugs that enhance energy metabolism in heart cells (Kudesan, Karnitin, Neurovitan).

Surgical treatment of such disorders can be carried out only with heart failure arising from advanced arrhythmias. The operation involves the introduction of a catheter into the right atrium, through which a blockage of bypasses for the propagation of the impulse is carried out. If the patient has frequent attacks of ventricular fibrillation, then a compact defibrillator can be implanted, which can minimize the risk of their occurrence.

Treatment

There is no point in treating the ECG phenomenon, because it has no symptoms and is not a disease. In order for the syndrome of early ventricular myocardial repolarization in children and adults not to develop into a more serious problem, doctors recommend:

  1. Visit them once every 6 months.
  2. Moderately engage in variety.
  3. Spend time outdoors.
  4. Eat well.
  5. Eliminate all bad habits.

Therapy of the disease is aimed at preventing the development of serious complications from cardiac activity. If life-threatening arrhythmias or other pathologies are identified, the patient is shown medication, and in some cases, surgery. An invasive method of treatment by radiofrequency ablation of an additional beam is used.

The correction of the patient’s lifestyle recommended by the attending physician is important. A patient with early repolarization is shown to limit physical activity and psycho-emotional stress. It is necessary to abandon bad habits (smoking, drinking alcohol) and patient compliance with a special diet, regular monitoring by a cardiologist.

Correction of the patient’s eating behavior is carried out in order to balance his daily diet and enrich him with B vitamins and microelements such as magnesium and potassium. You need to eat more raw vegetables and fruits, be sure to enter the menu of sea fish and seafood, liver, legumes and cereals, different types of nuts, fresh herbs, soy products.

Treatment with the use of medications is indicated only in the presence of concomitant pathologies of cardiac activity (arrhythmia, coronary syndrome, etc.). Drug therapy is necessary to prevent complications and the onset of acute critical conditions. Medications of the following pharmacological groups can be prescribed:

  • Energotropic drugs. Stop signs of the syndrome, improve the activity of the heart muscle. Possible appointments: Neurovitan (1 tablet per day), Kudesan (adult dosage – 2 mg per kilogram of weight), Carnitine (500 mg twice a day).
  • Antiarrhythmic drugs. Etmosine (100 mg 3 times a day), quin >

When aggravating the patient’s condition, severe clinical symptoms of moderate and high intensity (fainting, serious heart rhythm disturbances) that are not amenable to conservative treatment, doctors may recommend the necessary surgical intervention, including using minimally invasive methods. According to indications, the following operations are assigned:

  • Radiofrequency ablation (if additional pathways or severe arrhythmias are detected). Eliminating the extra beam helps eliminate arrhythmic disorders.
  • Implantation of a pacemaker (in the presence of life-threatening heart rhythm disturbances).
  • Implantation of a defibrillator-cardioverter (with ventricular fibrillation). A small device is placed under the skin on the chest, from which electrodes are introduced into the heart cavity. According to them, at the time of arrhythmia, the device transmits an accelerated electrical pulse, due to which normalization of the heart and restoration of the heart rhythm occur.

Prognosis of the disease

The prognosis for most patients with a diagnosed syndrome of premature cardiac ventricular repolarization is favorable. In some cases, the disease can threaten a critical situation for the patient’s life. The task of a cardiologist is to timely identify such a probability and minimize the dangerous consequences of heart rhythm disturbance.

Modern cardiology does not ignore symptoms such as AGR, as they may indicate the emergence of serious pathologies, and even fatal complications leading to sudden cardiac arrest. In this regard, patients with a revealed diffuse violation of the process of repolarization of the heart should systematically undergo ECG examinations, the purpose of which is to compare indicators in dynamics. Such monitoring of the development of pathology allows you to timely identify signs of other diseases.

For athletes there are special instructions, as well as the need for systematic examinations in physical education clinics. Here, their condition should be checked before and after intense training. Attention should be paid to the control of body functions during competitions.

To date, there is no exact information about the transition of this syndrome to any pathology. The likelihood of death is significantly increased with smoking, alcohol abuse and unhealthy diet. Therefore, a specific forecast can be made only by the results of a thorough diagnosis, which should be carried out with more or less regular intervals.

Early repolarization of the ventricles of the heart is a fairly common syndrome, which can be a precursor to the development of serious abnormalities in the body. For this reason, it is necessary to conduct a competent diagnosis and systematic observations by a doctor, which will help prevent the development of a dangerous ailment.

Ventricular Early Repolarization Syndrome – Symptoms

Very often, the ECG phenomenon is detected by chance during an examination for other diseases. Patients may not have any complaints or they are associated with the main diagnosis. Signs of the syndrome of early ventricular repolarization are manifested in the form of various arrhythmias, which are considered a serious threat to health and can lead to death (ventricular fibrillation).

Examination of an adult includes tests:

  • ECG monitoring for a day or more;
  • intravenous administration of procainamide to detect signs of anomaly on the device;
  • a test with potassium, when the patient takes the drug (dose is 2 g) for the manifestation of symptoms;
  • blood chemistry;
  • lipid profile.

If you suspect the presence of cardiac pathologies, a cardiogram is always done, the syndrome of early repolarization of the ventricles can appear on the device in the form of:

  • occurrence of an additional wave J in the QRS complex;
  • changes in the T wave when it has a broad base;
  • displacements of the electric axis to the left side;
  • changes in the shape of the ST particle, it rushes down, rises after the notch;
  • elevation (pseudocoronary elevation) of the ST segment in the chest leads above the contour (up to 3 mm).

Signs of anomalies can be seen at the site of the chest leads during ECG. It is worth paying attention to the S wave, because it can greatly decrease in size or an abyss from the thoracic branches on the left side. This indicator demonstrates to doctors that the human heart has made a turn along the longitudinal axis counterclockwise. In this case, the QRS complex (qR type) will be formed in the V5 and V6 regions.

During the examination, doctors can prescribe resting echocardiography (ECHO) and ECG, the syndrome of early repolarization of the ventricles in a child is best detected by these methods. They help to identify hidden abnormalities in the heart, give an idea of ​​the processes, rhythm and work of the main muscle. Such a diagnosis is absolutely safe for the health of children.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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