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Clinical Study on Dilated Cardiomyopathy in Children.

Journal of the Korean Pediatric Society 1988;31(4):446-466.
Published online April 30, 1988.
Clinical Study on Dilated Cardiomyopathy in Children.
Kweon Ha Son, Jun Hee Sul, Seung Kyu Lee, Dong Shik Chin
Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea
소아 확장성 심근증의 임상적 고찰
손권하, 설준희, 이승규, 진동식
연세대학교 의과대학 소아과학교실
Received: 10 September 1987   • Accepted: 10 November 1987
Abstract
A clinical assessment of the 30 patients with dilated cardiomyopathy who were admitted to the Department of Pediatrics, Yousei University Hospital from January, 1980 to June, 1986 was perfor- med. The results were as follows: 1) Among 30 patients of dilated cardiomyopathy, 11 cases (36%) were younger than 1 year of age and 6 cases (20%) were 1-2 years of age on admission. The male to female sex ratio was 2.3:1. 2) The etiology was discovered in 2 patients, which was the toxic effect of adriamycin, but in another 28, the etiology was not discovered. 3) On admission, congestive heart failure was noted in 27 cases (90%), fever in 10 cases (33%), heart murmur in 15 cases (50%), gallop sound in 8 cases (27%). 4) Among 11 cases with anemia, 9 were iron deficiency anemia. The levels of SGOT, LDH, and creatine kinase were elevated in 47%, 40%, 31%, respectively. 5) The electrocardiography showed left ventricular hypertrophy in 63%, nonspecific ST-T change in 30%, left atrial dilatation in 23%. The other findings were left and right axis deveation, right atrial dilatation, tachyarrhythmia, pattern of infarction and so on. 6) On chest X-ray, cardiomegaly was noted in all 30 cases, pulmonary venous congestion in 24 cases (80%) and pleural effusion in 6 cases (20%). 7) On echocardiographic examination, left ventricular and atrial dilatation were noted in all 30 cases, right ventricular dilatation in 4 cases (13%) and all cases with the mean level of 0.37 ±0.09 (mean±SD). 8) Of 15 cases followed up, 4 cases showed clinical improvement, but 6 cases were not improved and 5 cases were died during 6 to 60 months after treatment. These results suggest that clinical status at diagnosis is the most improtant factor on prognosis. So, the earlier the diagnosis and treatment are done, the more the prognosis of dilated cardiomyopathy improved.
Key Words: Dilated cardiomyopathy


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