Paraclinical cardiac findings of children with breath-holding Spells in Taleghani Hospital of Gorgan, Iran, during 2014–2016

Abstract

Context: Breath-holding spells (BHSs) are episodes of brief, involuntary cessation of breathing that occur in children in response to stimuli such as anger, frustration, fear, or injury. It occurs in about 0.1%–4.6% of healthy children. Although the etiology is not known, autonomic dysfunction and increased vagal tonus leading to cardiac arrest and cerebral anoxia are considered to play a role. Increase of QT dispersion increases the risk of sudden death. Because of this, children are always referred to cardiac clinics. Aims: Our aim was to evaluate According to these problems, our aim was the evaluation of ECG and Echocardiography findings in children diagnosed with BHSs in Taleghani Hospital in Gorgan. Settings and Design/ Methods and Material: All patients diagnosed with BHSs were enrolled in this study. In the first step, demographic characteristics and echocardiography and electrocardiogram (ECG) findings were obtained from the patients. Statistical Analysis Used: For statistical analysis, the demographic variables and ECG and echocardiography information of the patients were analyzed using frequency, percentage, and statistical tests such as Chi-square. Results: Sixty-three (9%) children were male and 36 (1%) children were female. Thirty-eight (9%) children were aged between 1 and 2 years, and this group was the most common age group. The most common type of attack was cyanotic (68/5%); 24 (1%) children had a positive family history, 78 (8%) had incomplete or absent iron supplementation, and 68% of children had anemia. Five (6%) children had long QT in ECG and five (6%) had abnormal echocardiography. There was a significant correlation between echocardiography findings and age, whereas there was no significant relationship between ECG findings with age, echocardiography findings with sex, and type of attack with age and sex. Conclusions: Although BHS among children with LQTS are relatively rare and occur at similar frequency as the general population, they can be the presenting symptom for a heart rhythm disorder.