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Clinical investigation on childhood HCM:long term follow-up study with special reference to electro-physiology, histopathology by endomyocardial biopsy and ambulatory and exercise electrocardiography Susumu Yonesaka 1 , Toshimasa Nakada 1 , Yoshiaki Sunagawa 1 , Toru Takahashi 1 , Toru Matubara 1 , Isamu Sekigami 1 , Terukazu Shiota 1 , Tukasa Sashinami 1 , Kazuhiko Tomimoto 1 , Hidetugu Furukawa 1 1Department of Pediatrics, Hirosaki University School of Medicine Keyword: 特発性肥大型心筋症(idiopathic hypertrohic cardiomyopathy) , 心内膜心筋生検(endomyocardial biopsy) , 心尖部肥大型心筋症(apical hypertrophic cardiomyopathy) pp.677-682
Published Date 1990/7/15
DOI https://doi.org/10.11477/mf.1404900179
  • Abstract
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In order to determine the prognosis and risk factors of childhood HCM, we investigated clinical parameters, such as the age of onset, symptomas and signs related to HCM, dysrhythmias and ST-T and changes by Holter ECG and exercise ECG, electrophysiological study and histopathological study by endomyocardial biopsy.

Heart murmur was the commonest sign although only one patient revealed a significant left ventri-cular outflow tract gradient of more than 20 mmHg. The peak age of patients diagnosed as having HCM was 10 to 15 years. The major ECG manifestations of our series showed specific findings and in some cases ECG changed remarkably during the follow-up period. The diagnosis of apical hypertrophy should be made with cauton in childhood. Holter ECG seemed to be indispensable for the follow-up of childhood HCM because Holter ECG in our patients manifested such significant findings as ven-tricular premature contractions or couplets or ST depression.

The degree of clinical severity did not always correlate with the histopathological severity obtained by endomyocardial biopsy. As HCM in childhood is heterogeneous and multifaceted, there is no one therapy, and prognosis and proper treatment with close observation should be carried out in each individual case.


Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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