In cardiology, there is such a thing as supraventricular crest syndrome. For people who are far from medicine, this diagnosis causes concern and they immediately begin to look for information about various methods of treating it. However, this is not worth doing at all. This syndrome does not pose any threat to human health. It is diagnosed mainly in children, which is associated with physiological factors. And in adults it is detected extremely rarely and is, as a rule, a consequence of past pathologies.
Etiology
The supraventricular crest is a bundle of muscle fibers of the heart, which is located in the right ventricle, between its posterior and anterior sections, and takes an active part in the so-called blood circulation. The right branch of the His bundle passes through it, and if its function is disrupted, they speak of the development of pancreatic crest syndrome.
Muscle fibers have the property of contracting. And since in children the heart beats much faster, an ECG reveals such changes. They are within normal limits and do not require third-party intervention, but only if the child has not previously had cardiac pathologies. If they were, then when diagnosing the syndrome, doctors also prescribe an ultrasound and after that it is determined whether the baby requires special treatment or not.
If, during the electrocardiogram, no noise was detected in the child and no complaints are received from him, then there is no need for therapy at all. As soon as the child’s body gets stronger and his heart begins to work like an adult’s, the signs of the syndrome on the ECG will disappear.
In people over 18 years of age, disturbances in the functioning of the supragastric scallop can provoke various pathologies:
- Heart disease.
- Ischemic disease.
- Angina pectoris.
- Arrhythmia, etc.
But it must also be said that in an adult, the presence of this syndrome does not have a negative effect on the functioning of the heart. Therefore, when making such a diagnosis, you simply need to periodically undergo an ECG. Treatment should be carried out only if an electrocardiogram reveals more serious disturbances in the functionality of the organ.
Causes
Scientists have not yet figured out why supraventricular crest syndrome occurs. This anatomical formation is a bundle of muscle fibers that pass through the middle of the right ventricle.
On the electroencephalogram, the syndrome looks like a split QRS wave in the fourth lead. It occurs only in thirty percent of cases of examination of clinically healthy preschool children.
For the appearance of this pathology, the position of the heart and the electrical potentials of the right and left ventricles play a role.
Symptoms
There are no characteristic signs for scallop syndrome. Its occurrence almost never causes any symptoms. In adults, it is recorded only on thermal paper during the study. If this phenomenon is complemented by a pronounced clinical picture (for example, the patient complains of pain or rapid heartbeat), then this, as a rule, is associated with the development of completely different pathologies.
But in children, the syndrome periodically makes itself felt. The child may complain about:
- Fatigue.
- Tachycardia.
- Shortness of breath.
- Minor dull pain in the chest.
The appearance of such a picture most often occurs after intense physical exertion. Once the body is given rest, symptoms disappear almost instantly. And the only confirmation of such abnormalities in the functioning of the heart, again, is an ECG.
Separately, we should talk about pain that occurs in the chest. The presence of this symptom is not yet a basis for confirming the diagnosis. The thing is that it can also appear in other pathologies, for example, pancreatitis or stomach ulcers. Therefore, to identify the exact cause of discomfort, it is necessary to undergo a more detailed examination.
Symptoms
Supraventricular crest syndrome does not manifest itself in any way. Some children may experience a feeling of fatigue, rapid fatigue after physical activity, or a feeling of palpitations - such complaints become the reason why the child is taken to the doctor. And the specialist already sees characteristic changes on the cardiogram.
Supraventricular crest syndrome rarely occurs in adults, but even if it occurs when taking an ECG, this is not a reason to panic, since it is considered by experts as a variant of the norm. Even without treatment, this phenomenon disappears without a trace and does not cause any concern.
Diagnostics
The only diagnostic method that can identify scallop syndrome is an electrocardiogram. And most often it is carried out for preventive purposes, so these deviations in 90% of cases are discovered completely by accident.
Since the syndrome is mainly detected in children, it is necessary to consider in more detail what criteria doctors use to make such a diagnosis. And these include:
- Increased amplitudes of teeth.
- The difference between contractions in the heart is 10% or more.
- Reduced line length of PQ, QT intervals.
- Deviation of the electrical axis of the heart to the right.
- Negative T waves in the V1-V3 pattern.
Identification of these signs in a child is an absolute norm, which is determined by the physical characteristics of the child’s body. If the syndrome is detected in an adult, then we can talk either about individual characteristics of the structure of the heart, or about the development of other pathologies. In the latter case, a more detailed examination is required to make an accurate diagnosis, which includes:
- Ultrasound.
- MRI.
- CT.
- Radiography.
- Laboratory tests of blood, urine, etc.
Important! Only a complete examination of the patient allows an accurate diagnosis to be made. Carrying out an ECG and taking an anamnesis alone is not enough.
Pathogenesis
A child’s cardiogram has its own physiological and pathological characteristics. It is worth saying that changes in it depend on the age of the patient, when, as for an adult, there is a single norm. Among the “children’s” features we can list the shortening of the PQ and QT intervals, the GRS complex also narrows, and sometimes arrhythmia can be observed, while maintaining a positive P wave.
Pathophysiologists explain these phenomena by the fact that a child’s heart beats faster than an adult’s. Action potentials shift and layer on top of each other. Or the excitation does not have time to cover all cardiomyocytes before contraction - this is how artifacts appear on the ECG.
Supraventricular crest syndrome is one such physiological phenomenon. Its presence does not indicate any pathology, so doctors do not focus attention on it and over time the child outgrows it.
Treatment
Scallop syndrome does not require treatment. Its presence does not in any way affect the functioning of the heart or the quality of life. But imaginary patients often demand that they be prescribed therapy. In such situations, the doctor can only prescribe multivitamin complexes and drugs that help strengthen the cardiovascular system.
If the syndrome is detected, the following medications may be prescribed:
- Vitamins for intramuscular administration (A, C, E, P, B1, etc.).
- Minerals for intramuscular administration (magnesium, calcium, selenium, etc.).
- "Asparkam."
- "Ascorutin".
In addition, lifestyle adjustments are also recommended:
- Reducing physical activity.
- Proper nutrition.
- Rejection of bad habits.
- Walks in the fresh air (at least 20 minutes a day).
Possible complications
Scallop syndrome, although not a pathology, can lead to serious consequences, especially if a person is at risk, for example:
- Is overweight.
- Engaged in work activities that require strong physical exertion.
- Suffers from hypertension and cholesterol disease.
- Hereditarily predisposed to heart pathologies.
- Abuses alcohol.
In this case, an incomplete block of the His bundle may occur, which is characterized by a disruption in the process of conducting an electrical impulse. However, this condition is not accompanied by any serious changes in the myocardium and has virtually no effect on a person’s quality of life.
But if the patient neglects the doctor’s recommendations, leads a passive lifestyle, eats poorly, smokes and abuses alcohol, then pectineus syndrome can provoke a complete transverse block of the His bundle and the development of other cardiac pathologies (for example, a heart attack).
It is important to understand that scallop syndrome is a normal phenomenon that occurs in 60% of children and 10% of adults. And if you lead a healthy lifestyle, then its presence will not affect your overall health. With such a diagnosis, a child may well play sports and play with his peers on the street. The main thing is to constantly monitor his diet so that the body regularly receives all the necessary nutrients. And if you do everything correctly, then after the heart is fully formed (this happens closer to the age of 18), the electrocardiogram readings will return to normal.
Unfortunately, some parents are faced with a cardiologist’s diagnosis of “WPW phenomenon” or “WPW syndrome.”
Let's immediately determine how they differ, as this is important for determining further tactics in the examination and treatment of patients. With the WPW phenomenon, the patient does not have any external clinical manifestations (doctors sometimes use the terms asymptomatic or asymptomatic WPW), and only its special signs are recorded on the ECG, indicating the passage of the impulse along a faster path than it should normally be. With the syndrome, in addition to changes in the ECG, tachycardia appears, accompanied by certain symptoms.
WPW syndrome is dangerous due to the high risk of developing prognostically unfavorable rhythm disturbances (most often reciprocal supraventricular tachycardia, atrial fibrillation or flutter), which without adequate treatment can develop into life-threatening arrhythmias and lead to cardiac arrest.
The reason for the occurrence of such serious changes in rhythm is a congenital pathology in the structure of the conduction pathways of the heart, the essence of which is the existence of abnormal/additional pathways for conducting impulses.
Diagnosis of WPW is simple - first of all, you need to do an ECG.
There are so-called family variants of WPW, so if you or your children have been diagnosed with this phenomenon, it makes sense to do an ECG for all family members. The disease can manifest itself at any age, or it may not manifest itself at all throughout life.
What to do if a WPW phenomenon is detected (when changes are recorded only on the ECG, there are no clinical manifestations of the disease)? First of all, it is necessary to contact a cardiologist, who, after a thorough examination of the child, will give recommendations on additional examination (usually echocardiography, Holter ECG monitoring; less often TEE, EPI), and will also give recommendations on lifestyle (for example, what physical activities are allowed and what prohibited), and will also prescribe treatment if necessary. A patient with the WPW phenomenon should be regularly monitored by a cardiologist!
The trigger for the occurrence of the rhythm disturbances described above can be: physical activity, stress, emotional overexcitement, alcohol, coffee, and what is very important in the modern world - the use of specific substances (taking narcotic and psychoactive drugs, narcotic smoking mixtures). We should not forget that rhythm disturbances can develop suddenly, without provocation! This is the insidiousness of WPW.
During an attack, there is a feeling of a sinking heart or, on the contrary, a more frequent heartbeat, a feeling of lack of air, dizziness, fainting, there may be pain in the heart area, coldness of the extremities, a feeling of fear, a “gurgling” sensation in the throat, in the heart area. Such an attack can last from a few seconds to several hours. Sometimes it goes away on its own. If such symptoms appear in a child with a diagnosed WPW phenomenon, immediate medical attention is required (call an ambulance). If such an attack has happened at least once, you must understand that it can happen again; the child should not be left alone unattended.
The presence of such symptoms (this is already WPW syndrome) radically changes the approach to treating the patient: the cardiologist may prescribe antiarrhythmic therapy, transesophageal pacing, catheter RFA.
Dear parents, you must be prepared for the development of the disease in any of the areas described above. Be careful and listen to your child. If your child has been diagnosed with “WPW phenomenon” and especially “WPW syndrome”, you should inform the medical worker of the school or preschool where the child attends, as well as the teacher/educator, so that in the event of an attack, the child can receive timely medical assistance.
