Follow-Up and Community Care of the Child With a Chronic Disease

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DOI :10.26650/B/CH32.2024.010.020   IUP :10.26650/B/CH32.2024.010.020    Full Text (PDF)

Follow-up and Community Care of the Child with Rhythm Disorders

Merve Maze Aydemir, Yakup Ergül

Rhythm disorders are frequent reasons for admission to pediatric outpatient clinics and emergency services. Several cases of rhythm disorders occur without structural heart disease, and more complicated rhythm disorders have become common in daily practice after diagnosis and treatment of congenital heart diseases. Rhythm disorders range from asymptomatic course, to sudden cardiac death, to severe rhythm disturbances presenting for the first time. Therefore, to correctly diagnose these diseases, anamnesis, physical examination, and a detailed ECG evaluation are essential. When a life-threatening rhythm disorder develops, the hemodynamics should be analyzed, to perform correct and adequate cardiopulmonary resuscitation in case of unstable hemodynamics, or to administer the proper medication for the detected arrhythmia in stable patients. In the post-diagnosis period, it is vital to closely monitor the changes that may occur in the course of the disease, control treatment compliance, detect complications caused by the treatment, proceed to the next treatment step when necessary, confirm the need for a pacemaker, etc. This chapter compiles the points that the physician should consider in the management of rhythm disorders and the points that the children and their families should be warned about during follow-up.


Keywords: Arrhythmia, AV block, pacemaker, supraventricular tachycardia, ventricular tachycardia
DOI :10.26650/B/CH32.2024.010.020   IUP :10.26650/B/CH32.2024.010.020    Full Text (PDF)

Ri̇ti̇m Bozukluğu Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Merve Maze Aydemir, Yakup Ergül

Ritim bozuklukları, pediatri polikliniklerine ve acil servislere sık başvuru nedenlerindendir. Yapısal bir kalp hastalığı olmaksızın karşımıza çıkabilen pek çok ritim bozukluğunun yanı sıra konjenital kalp hastalıklarının takip ve tedavilerinde artış sonrasında daha komplike ritim bozuklukları da günlük pratiklerde karşılaşılır boyutlara gelmiştir. Ritim bozuklukları asemptomatik seyirden ani kardiyak ölüm ile ilk kez bulgu veren ciddi ritim bozukluklarına kadar çok geniş bir spektrumun parçası olabilmektedir. Bu nedenle bu hastalıkların iyi tanınması, öykü, fizik muayene, iyi bir 12 kanal elektrokardiyografi (EKG) değerlendirmesi çok önemlidir. Aynı zamanda yaşamı tehdit eden bir ritim bozukluğu geliştiğinde hemodinamiğin değerlendirilmesi, hemodinamisi stabil olmayan çocuklarda doğru ve yeterli kardiyopulmoner resüsitasyon yapılması, stabil olgularda saptanan aritmiye uygun ilaç ve dozun verilmesi hayati önem taşımaktadır. Yine acil müdahalede kaçınılması gereken noktalar da hayati öneme sahiptir Tanı sonrasındaki süreçte de hastalığın seyrinde olabilecek değişikliklerin iyi izlenmesi, tedavi uyumunun kontrolü, tedaviye bağlı karşılaşılabilecek komplikasyonlar, gerektiğinde tedavi basamaklarında ilerleme, “pacemaker” ihtiyacı gelişimi vb durumlar açısından da takibi hayati önem arz etmektedir. Bu yazıda ritim bozukluklarının izleminde hem hekimin süreç yönetiminde göz önünde bulundurması gerekenler hem de çocuk ve ailesinin uyarılması gereken noktalar derlenmeye çalışılmıştır. 


Keywords: Aritmi, AV blok, pacemaker, supraventriküler taşikardi, ventriküler taşikardi

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