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• W2793399405 abstract "Article| March 01 2018 Left Axis Deviation in Children Without Previously Known Heart Disease Andrew E. Schneider, MD; Andrew E. Schneider, MD aDivision of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Search for other works by this author on: This Site PubMed Google Scholar Bryan C. Cannon, MD; Bryan C. Cannon, MD aDivision of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Search for other works by this author on: This Site PubMed Google Scholar Jonathan N. Johnson, MD; Jonathan N. Johnson, MD aDivision of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Search for other works by this author on: This Site PubMed Google Scholar Michael J. Ackerman, MD; Michael J. Ackerman, MD aDivision of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine,bDivision of Heart Rhythm Services, Department of Cardiovascular Diseases, andcDepartment of Molecular Pharmacology and Experimental Therapeutics and Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, Minnesota Search for other works by this author on: This Site PubMed Google Scholar Philip L. Wackel, MD Philip L. Wackel, MD aDivision of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Address correspondence to Philip L. Wackel, MD, Mayo Clinic, 200 First St SW, Gonda 6, Rochester, MN 55905. E-mail: wackel.philip@mayo.edu Search for other works by this author on: This Site PubMed Google Scholar Address correspondence to Philip L. Wackel, MD, Mayo Clinic, 200 First St SW, Gonda 6, Rochester, MN 55905. E-mail: wackel.philip@mayo.edu POTENTIAL CONFLICT OF INTEREST: Dr Ackerman is a consultant for Audentes Therapeutics, Boston Scientific, Gilead Sciences, Invitae, Medtronic, MyoKardia, and St. Jude Medical. Dr Ackerman and Mayo Clinic have a potential equity and/or royalty relationship with AliveCor, Blue Ox Health, and StemoniX. However, none of these entities have participated in this study in any way; the other authors have indicated they have no potential conflicts of interest to disclose. FINANCIAL DISCLOSURE: Other than those already listed under Potential Conflict of Interest, the other authors have indicated they have no financial relationships relevant to this article to disclose. Pediatrics (2018) 141 (3): e20171970. https://doi.org/10.1542/peds.2017-1970 Article history Accepted: December 05 2017 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Andrew E. Schneider, Bryan C. Cannon, Jonathan N. Johnson, Michael J. Ackerman, Philip L. Wackel; Left Axis Deviation in Children Without Previously Known Heart Disease. Pediatrics March 2018; 141 (3): e20171970. 10.1542/peds.2017-1970 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP Grand RoundsAAP NewsAll AAP Sites Search Advanced Search BACKGROUND:Left axis deviation (LAD) discovered in children via electrocardiogram (ECG) is uncommon but can be associated with heart disease (HD). The optimal diagnostic approach in a seemingly healthy child with LAD is unclear. We sought to better stratify which patients with LAD but without previously known HD may warrant additional workup.METHODS:A retrospective chart review was performed to identify patients ≥1 to <18 years of age with LAD (QRS frontal plane axis 0 to −90) on an ECG between January 2002 and December 2014. Patients with known HD before their initial ECG were excluded.RESULTS:Overall, 296 patients were identified (n = 181 [61%] male; mean age: 10.8 ± 4.6 years; mean QRS axis: −24 ± 22°). An echocardiogram was performed in 158 (53%) patients, with 24 (15%) having HD. Compared with those with an echocardiogram but without HD (n = 134), patients with HD had a more negative mean QRS axis (−42 vs −27°; P = .002) and were more likely to have a QRS axis ≤−42° (58% vs 26%; P = .003), ECG chamber enlargement or hypertrophy (38% vs 5%; P < .0001), and abnormal cardiac physical examination findings (75% vs 8%; P < .0001).CONCLUSIONS:LAD discovered in isolation in the asymptomatic pediatric patient may not necessitate further cardiovascular investigation. Clinicians should consider obtaining an echocardiogram in patients with LAD and ECG cardiac chamber enlargement or hypertrophy, a QRS axis ≤−42°, and/or the presence of abnormal cardiac physical examination findings. Subjects: Cardiology, Cardiovascular Disorders Topics: echocardiography, heart, heart diseases, hypertrophy, left axis deviation, qrs axis, electrocardiogram, echocardiography, transthoracic Copyright © 2018 by the American Academy of Pediatrics2018 You do not currently have access to this content." @default.
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• W2793399405 title "Left Axis Deviation in Children Without Previously Known Heart Disease" @default.
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