![]() ![]() Although ASD rarely cause PH in younger age, closure of ASD with PH in children still carries a significant morbidity and mortality despite after a proper assessment of operability of ASD in a low-to-middle-income countries. ASD associated with pulmonary arterial hypertension (PH) presents with various clinical scenarios from large defect without or only mild PH, large defect with irreversible PH and a few case with small defect with severe disproportionate PH. A total score ≥ 3.5 shows a moderate sensitivity and high specificity to predict PH among children with ASD.Ītrial septal defect (ASD) is one of the most common left to right shunt congenital heart diseases in children. ConclusionsĪ presence of PH in children with ASD can be predicted by the simple electrocardiographic score including QRS axis ≥120°, P wave ≥3 mm at lead II, R without S at V1, Q wave at V1, RBBB, R wave at V1, V2 or aVR > normal limit and S wave at V6 or lead I > normal limit. ROC curve from prediction scores yielded an area under the curve (AUC) 0.908(95% CI 0.85–0.96). Predictors of pulmonary hypertension were QRS axis ≥120°, P wave ≥ 3 mm at lead II, R without S at V1, Q wave at V1, right bundle branch block (RBBB), R wave at V1, V2 or aVR > normal limit and S wave at V6 or lead I > normal limit. Accuracy of prediction score was performed using a receiver operating characteristic (ROC) curve. Spiegelhalter Knill-Jones approach was used to develop PH prediction score. Diagnosis of ASD and PH was confirmed through echocardiography and/or cardiac catheterization. MethodsĪ cross-sectional study reviewing medical record including ECG record was conducted among all children with newly diagnosed isolated ASD admitted to Dr Sardjito Hospital in Yogyakarta, Indonesia during 2016–2018. ![]() We aimed to develop a PH prediction score using electrocardiography parameters for children with ASD in Indonesia. No scoring system has been proposed to predict PH among children with ASD. Echocardiography and cardiac catheterization are not widely available in such settings. In limited resource settings, identification of factors that predict the occurrence of pulmonary hypertension(PH) in children with atrial septal defect(ASD) is important to decide which patients should be prioritized for defect closure to prevent complication. ![]()
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