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Mekoulou Ndongo J, Assomo Ndemba PB, Temfemo A, Dzudie Tamdja A, Abanda MH, Bika Lele EC, Tchoudjin E, Guessogo WR, Gassina LG, Mandengue SH. Pre- and post-exercise electrocardiogram pattern modifications in apparently healthy school adolescents in Cameroon. Int J Adolesc Med Health 2017; 31:/j/ijamh.ahead-of-print/ijamh-2017-0071/ijamh-2017-0071.xml. [PMID: 28779570 DOI: 10.1515/ijamh-2017-0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/14/2017] [Indexed: 11/15/2022]
Abstract
Background Physical Education and Sport (PES) is compulsory in Cameroonian education system. Cardiac accidents and sudden cardiac deaths (SCD) have been reported during PES examinations. This study aimed to contribute in the prevention of these cardiac accidents by studying pre- and post-exercise electrocardiogram (ECG) pattern modifications in apparently healthy school adolescents. Methods One hundred school adolescents without apparent heart disease [aged 18 ± 2 years; body mass index (BMI): 21.9 ± 2.3] were included. Participants performed two intermittent sprint-endurance tests. The test consisted in walking 2000 m as warm-up, followed by sprint and endurance races. A 12-leads ECG was performed before and in 5 min after the tests. ECG patterns changes were studied with particular attention to abnormalities that could be associated with risk of SCD. Results At rest, ECG patterns variants consisted of bradycardia (30%), sinus arrhythmia (9%), posterior hemi post-block (2%), and early repolarization (3%). which disappeared after exercise in all participants. QTc (ms) and heart rate (HR) increased after exercise (p < 0.001); and RR (ms) decreased post-exercise (p < 0.001). Other changes includes the appearance of the T-waves reversed in precordial leads (V2-V4) (p < 0.001), ventricular (6%), atrial and other supraventricular premature beats (2%) in the post-exercise ECG. Left ventricular hypertrophy (2%), right auricular enlargement (2%), short PR (2%) appeared at the end of the tests. Conclusion This study suggests that an intermittent exercise can induce cardiac abnormalities able to provoke cardiac accidents and SCD in apparently healthy school adolescents.
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Affiliation(s)
- Jerson Mekoulou Ndongo
- Exercise and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Peguy Brice Assomo Ndemba
- Exercise and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Abdou Temfemo
- Exercise and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon.,Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Anasthase Dzudie Tamdja
- Department of Non-Communicable Diseases, Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon.,Department of Internal Medicine, Douala General Hospital, Douala, Cameroon
| | - Martin Hongieh Abanda
- Department of Non-Communicable Diseases, Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon
| | - Elysée Claude Bika Lele
- Exercise and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Ernest Tchoudjin
- Exercise and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Wiliam Richard Guessogo
- Exercise and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon.,National Institute for Youth and Sports Yaoundé, Yaounde, Cameroon
| | - Louis-Georges Gassina
- Exercise and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Samuel Honoré Mandengue
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.,Exercise and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, P.O. Box 7064, Douala, Cameroon, Phone: (+00237) 698 48 63 00
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Abstract
Sudden cardiac arrest (SCA) in the pediatric population is a rare and potentially devastating occurrence. An understanding of the differential diagnosis for the etiology of the cardiac arrest allows for the most effective emergency care and provides the patient with the best possible outcome. Pediatric SCA can occur with or without prodromal symptoms and may occur during exercise or rest. The most common cause is arrhythmia secondary to an underlying channelopathy, cardiomyopathy, or myocarditis. After stabilization, evaluation should include electrocardiogram, chest radiograph, and echocardiogram. Management should focus on decreasing the potential for recurring arrhythmia, maintaining cardiac preload, and thoughtful medication use to prevent exacerbation of the underlying condition. The purpose of this review was to provide the emergency physician with a concise and current review of the incidence, differential diagnosis, and management of pediatric patients presenting with SCA.
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The Impending Dilemma of Electrocardiogram Screening in Athletic Children. Pediatr Cardiol 2016; 37:1-13. [PMID: 26289947 DOI: 10.1007/s00246-015-1239-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/31/2015] [Indexed: 10/23/2022]
Abstract
Sudden cardiac death (SCD) affects 2/100,000 young, active athletes per year of which 40% are less than 18 years old. In 2004, the International Olympic Committee accepted the Lausanne Recommendations, including a 12-lead electrocardiogram (ECG), as a pre-participation screening tool for adult Olympic athletes. The debate on extending those recommendations to the pediatric population has recently begun. The aims of our study were to highlight the characteristics of the young athlete ECG, phenotypical manifestations of SCD-related disease in children, and challenges of implanting ECG screening in athletic children. A systematic review of the literature is performed. We searched available electronic medical databases for articles relevant to SCD, ECG, silent cardiac diseases, and athletic children. We focused on ECG screening and description in a pediatric population. We identified 2240 studies. Sixty-two relevant articles and one book were selected. In children, prepubertal ECG and the ECG phenotype of most SCD-related diseases differ notably from adults. The characteristics of the prepubertal ECG and of the phenotypical manifestation of SCD-related disease in children will result in less specific and less sensitive ECG-based screening programs. Those limitations advise against extending the adult recommendation to children, without further studies. Until then, history and physical exam should remain the cornerstone of screening for SCD-related pathologies in children.
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