Profile and Outcome of Dilated Cardiomyopathy in Children: A Short- term Follow up
Journal Title: Journal of Medical Research and Practice - Year 2017, Vol 6, Issue 1
Abstract
Introduction Dilated cardiomyopathy (DCM) is the most common childhood cardiomyopathy and is associated with considerable morbidity and mortality. Though less common, DCM is a serious disorder. Risk stratification of children with DCM is important to plan management and to predict morbidity and mortality. Aims To study the clinical profile of DCM in children and the risk factors predicting the short-term outcome of DCM in children. Methods and Materials Study design: Descriptive study. Study place: Chengalpattu Medical College. Study period: 2 years. Study population: Children admitted/attending pediatric department. Results About 41.9% cases were less than 12 months old. No gender difference was present. 92.7% had congestive cardiac failure at presentation with NYHA class III-IV. All of them had tachycardia and tachypnea for their age and cardiomegaly at presentation. Left ventricular hypertrophy was present in 60% of patients. Serology showed positive for coxsackie B infection in 7 (12.73%) of cases. Three of them were retrovirus positive. All of them presented with left ventricular systolic dysfunction with depressed ejection fraction and fractional shortening. 38 (69%) children showed clinical and echocardiographic improvement on follow up and in 4 (7.2%) children all medications have been stopped. Among the 17, 11 children died and 6 children did not show significant clinical and echocardiographic improvement. Out of 11 children who died, 7 were during the first admission and the remaining within 6 months of presentation. Conclusion Fractional shortening <15% and ratio of left ventricular end diastolic dimension to posterior wall thickness in diastole >8 are the independent predictors for poor short-term outcome on multivariate analysis.
Authors and Affiliations
S. Sudha
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