Early Detection of Cardiac Involvement in Beta-Thalassemia Children
KRITVIKROM DURONGPISITKUL, M.D.*, SIWILUCK KRUASUKON, M.D.**, CHARUWAN KANGKAGATE, B.Sc., M.Sc.***, VORA VARN S. T ANPHAICHITR, M.D., M.S.****
Affiliation : * Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol Univer sity, Bangkok 10700, ** Mother and Children Hospital, Khon Kaen 40002, *** Her Majesty Cardiac Center, **** Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol Univer sity, Bangkok 10700, Thailand.
Patients and
Method : The authors studied beta-thalassemia major and beta-thalassemia/ HbE patients who came to the clinic between July 1'' 1999 and July 31" 2000. There were 211 asymptomatic patients included in study. Their ages ranged from 2.6 to 18.2 years. Previous clinical history including blood transfusion and iron chelation were recorded. All patients received a thorough physical examination, chest X-ray, electrocardiogram and echocardiogram. Patients who had abnormal systolic or diastolic function detected by echocardiogram were identified as having cardiac involve- ment.
Results : Cardiac involvement was found in 26 patients (12.3%). There was no difference in physical examination between patients who had and did not have cardiac involvement. Abnormal chest X-Ray defined as cardiothoracic (CT) ratio>0.55 and electrocardiogram (ECG) findings of left or right ventricular hypertrophy were associated with cardiac involvement. Other associated findings were older age and lower average pretransfusion hematocrit (23 ± 6.6% ).
Conclusions : In asymptomatic beta-thalassemia children, chest X-ray and ECG should be used for screening patients for the detection of cardiac involvement.
Keywords : Beta-Thalassemia, Cardiac Involvement, Children, Thailand
