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[The ABC of paediatric ECG interpretation]
Caroline Fransson1, Stefan Johansson2, Cecilia Halvorsen3
1Sachsska Barnsjukhuset - Stockholm, Sweden - Sachsska Barn- och Ungdomssjukhuset, Södersjukhuset Stockholm, Sweden.
Insights
This guide explains paediatric electrocardiogram (ECG) interpretation, highlighting age-related normal values and common abnormalities in children. It aids in identifying conditions like arrhythmias and congenital heart issues.
Area of Science:
- Pediatric Cardiology
- Clinical Electrocardiography
Background:
- Electrocardiograms (ECGs) are crucial for diagnosing pediatric conditions such as arrhythmias, chest pain, syncope, intoxications, and congenital heart abnormalities.
- Pediatric ECGs exhibit significant age-related variations from adult ECGs due to physiological changes, particularly the transition from fetal circulation after birth, with notable evolution during the first year and into late adolescence.
Purpose of the Study:
- To provide a practical guide for interpreting pediatric ECGs.
- To outline normal age-related ECG parameters and identify pathological changes.
Main Methods:
- Presentation of normal age-related values for key pediatric ECG parameters.
- Description of common pathological ECG findings in children, including arrhythmias and ST changes.
- Guidance on patient referral to pediatric cardiology specialists.
Main Results:
- Normal pediatric ECGs feature higher heart rates, narrower QRS complexes, negative T-waves in right precordial leads, and a rightward electrical axis in younger children.
- Pathological findings include tachyarrhythmias, bradyarrhythmias, ST segment changes, and prolonged QT intervals.
Conclusions:
- Accurate interpretation of pediatric ECGs requires understanding age-specific normal values and recognizing deviations.
- This article serves as a foundational resource for clinicians managing pediatric cardiac conditions through ECG analysis.
Abstract:
The ABC of paediatric ECG interpretation In paediatric patients, ECG is used as a tool for investigation of arrhythmias, chest pain, syncope, intoxications and congenital heart abnormalities. Paediatric ECGs differ significantly from adult ECGs, and change gradually during childhood, largely because of the changes that start with the transition of foetal circulation at birth. This evolution is most prominent during the first year of life, but it is not until the late adolescent years that the ECG corresponds to that of adults. This article focuses on practical paediatric ECG interpretation. The first section presents normal age-related values for different ECG parameters. For example, in small children heart rate is higher, QRS-complexes narrower, T-waves in right precordial leads are negative, and the electrical axis rightward. Then, pathological changes in ECG are presented, e.g. tachy- and bradyarrhythmias, ST changes and long QT. Finally, we suggest which patients to refer to a specialist in paediatric cardiology.
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