Association of gastroesophageal reflux and chest pain in children with mitral valve prolapse
Year 2019,
Volume: 18 Issue: 1, 2 - 6, 29.04.2019
Serkan Fazlı Çelik
,
Eylem Sevinç
,
Elif Çelik
,
Erkan Doğan
Abstract
Background and Aims: To date, few studies have investigated the association of pediatric functional gastrointestinal diseases with mitral valve prolapse and chest pain. We aimed to describe the relationship between chest pain and gastroesophageal reflux disease in children with mitral valve prolapse. Materials and Methods: This study included 70 pediatric patients with mild-to-moderate mitral valve prolapse with complaints of typical upper gastrointestinal system symptoms and chest pain. The patients were treated with medical anti-reflux drug therapy for 8 weeks. Before and after treatment, the patients were assessed with the Gastroesophageal Reflux Disease Impact Scale. Results: The mean patient age was 13.24±2.81 years, and 42 (60%) patients were female. The duration of symptoms in 30 patients was longer than 6 weeks, and that of 40 patients was shorter than 6 weeks. The mean symptom duration of all patients was 8±2.2 weeks. The most frequently reported symptom was chest pain (89.9%), followed by regurgitation (50%). Compared with children who had chronic gastroesophageal reflux, children with recent, acute gastroesophageal reflux reported significantly more frequent and severe symptoms. There was no significant relationship between the severity of mitral valve prolapse and symptoms. Gastroesophageal Reflux Disease Impact Scale scores of all patients were significantly decreased after treatment (p < 0.01). Although both groups of patients benefited from treatment, it was found that patients with newly diagnosed gastroesophageal reflux disease benefited significantly more from treatment than patients with chronic disease. Conclusion: Many preadolescents and adolescents with mitral valve prolapse and chest pain had symptomatic gastroesophageal reflux disease. Specific diagnosis and therapy for gastroesophageal reflux disease alleviated chest pain in most patients.
References
- Referanslar
1. Woolf PK, Gewitz MH, Berezin S, et al. Noncardiac chest pain in adolescents and children with mitral valve prolapse. J Adolescent Health 1991;12:247-50.
2. Fyfe DA, Moodie D. Chest pain in pediatric patients presenting to a cardiac clinic. Clin pediatr 1984; 23:321-4.
3. Spears PF, Koch KL. Esophageal disorders in patients with chest pain and mitral valve prolapse. Am J Gastroenterol 1986;81:951-4.
4. Vakil N, Van Zanten SV, Kahrilas P, et al; Globale Konsensusgruppe. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900-20.
5. Modlin I, Hunt R, Malfertheiner P, et al; Vevey NERD Consensus Group. Diagnosis and management of non-erosive reflux disease-the Vevey NERD Consensus Group. Digestion 2009;80:74-88.
6. De Leone, A, Tonini M, Dominici P, et al; EMERGE Study Group. The proton pump inhibitor test for gastroesophageal reflux disease: optimal cut-off value and duration. Dig Liver Dis 2010; 42:785-90.
7. Jones R, Coyne K, Wiklund I. The gastro‐oesophageal reflux disease impact scale: a patient management tool for primary care. Aliment Pharmacol Ther 2007; 25:1451-9.
8. Fox M. and Forgacs I. Unexplained (non-cardiac) chest pain. Clin Med 2006;6:445-9.
9. Sabri MR, Ghavanini AA, Haghighat M, Imanieh MH. Chest pain in children and adolescents: epigastric tenderness as a guide to reduce unnecessary work-up. Pediatr Cardiol 2003;24:3-5.
10. Diercks DB, Kirk JD, Amsterdam EA. Chest pain units: management of special populations. Cardiol Clin 2005;23:549-57.
11. Hammett RJ, Hansen RD, Lorang M, et al. Esophageal dysmotility and acid sensitivity in patients with mitral valve prolapse and chest pain. Dis Esophagus 2003;16:73-6.
12. Stanghellini, V, Armstrong D, Mönnikes H, Bardhan KD. Systematic review: do we need a new gastro-oesophageal reflux disease questionnaire? Digestion 2007;75:3-16.
13. Liker H, Hungin P, Wiklund, I. Managing gastroesophageal reflux disease in primary care: the patient perspective. J Am Board Fam Pract 2005;18:393-400.
14. Smith MS, Doroshow C, Womack WM, et al. Symptomatic mitral valve prolapse in children and adolescents: catecholamines, anxiety, and biofeedback. Pediatrics 1989;84:290-5.
Göğüs ağrısı olan mitral kapak prolapsuslu çocuk hastalarda gastroözofageal reflü birlikteliği
Year 2019,
Volume: 18 Issue: 1, 2 - 6, 29.04.2019
Serkan Fazlı Çelik
,
Eylem Sevinç
,
Elif Çelik
,
Erkan Doğan
Abstract
Giriş ve Amaç: Göğüs ağrısı ve mitral kapak prolapsusu olan çocuklarda fonksiyonel gastrointestinal hastalıkların göğüs ağrısıyla ilişkisini araştıran az sayıda çalışma vardır. Bu çalışmada mitral kapak prolapsusu olan çocuklarda göğüs ağrısı ve gastroözofageal reflü hastalığı arasındaki ilişkiyi tanımlamayı amaçladık. Gereç ve Yöntem: Çalışmaya, tipik üst gastrointestinal sistem semptomları ve göğüs ağrısı tanımlayan, hafif ile orta mitral kapak prolapsusu olan 70 çocuk hasta dahil edildi. Hastalar sekiz hafta süreyle anti-reflü ilaç tedavisi ile tedavi edildi. Tedaviden önce ve sonra hastalar gastroözofageal reflü hastalığı etki ölçeği ile değerlendirildi. Bulgular: Hastaların yaş ortalaması 13.24±2.81 yıldı ve 32'si (%60) kızdı. 30 hastanın semptomları 6 haftadan daha fazla ve 40 hastanın semptomları 6 haftadan az süredir mevcuttu. Tüm hastaların ortalama semptom süresi 8±2.2 haftaydı. En çok bildirilen semptom göğüs ağrısı (%89.9) ve ardından regürjitasyon (%50) idi. Kronik gastroözofageal reflü olan çocuklarla karşılaştırıldığında, yeni gastroözofageal reflü tanısı alan çocuklarda anlamlı olarak daha sık ve ciddi semptomlar vardı. Mitral kapak prolapsusunun şiddeti ile semptomlar arasında anlamlı bir ilişki bulunmadı. Gastroözofageal reflü hastalığı etki ölçeği skorları, tedaviden sonra tüm hastalarda istatistiksel olarak azalmıştı (p <0.01). Her iki hasta grubu tedaviden fayda sağlasa da, gastroözofageal reflü hastalığı yeni saptanan hastalar, kronik hastalardan daha fazla tedaviden fayda gördüler. Sonuç: Mitral kapak prolapsusu ve göğüs ağrısı olan birçok çocuk hastada semptomatik gastroözofageal reflü hastalığı mevcuttur. Gastroözofageal reflünün spesifik tanısı ve tedavisi çoğu hastada göğüs ağrısını hafifletmiştir.
References
- Referanslar
1. Woolf PK, Gewitz MH, Berezin S, et al. Noncardiac chest pain in adolescents and children with mitral valve prolapse. J Adolescent Health 1991;12:247-50.
2. Fyfe DA, Moodie D. Chest pain in pediatric patients presenting to a cardiac clinic. Clin pediatr 1984; 23:321-4.
3. Spears PF, Koch KL. Esophageal disorders in patients with chest pain and mitral valve prolapse. Am J Gastroenterol 1986;81:951-4.
4. Vakil N, Van Zanten SV, Kahrilas P, et al; Globale Konsensusgruppe. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900-20.
5. Modlin I, Hunt R, Malfertheiner P, et al; Vevey NERD Consensus Group. Diagnosis and management of non-erosive reflux disease-the Vevey NERD Consensus Group. Digestion 2009;80:74-88.
6. De Leone, A, Tonini M, Dominici P, et al; EMERGE Study Group. The proton pump inhibitor test for gastroesophageal reflux disease: optimal cut-off value and duration. Dig Liver Dis 2010; 42:785-90.
7. Jones R, Coyne K, Wiklund I. The gastro‐oesophageal reflux disease impact scale: a patient management tool for primary care. Aliment Pharmacol Ther 2007; 25:1451-9.
8. Fox M. and Forgacs I. Unexplained (non-cardiac) chest pain. Clin Med 2006;6:445-9.
9. Sabri MR, Ghavanini AA, Haghighat M, Imanieh MH. Chest pain in children and adolescents: epigastric tenderness as a guide to reduce unnecessary work-up. Pediatr Cardiol 2003;24:3-5.
10. Diercks DB, Kirk JD, Amsterdam EA. Chest pain units: management of special populations. Cardiol Clin 2005;23:549-57.
11. Hammett RJ, Hansen RD, Lorang M, et al. Esophageal dysmotility and acid sensitivity in patients with mitral valve prolapse and chest pain. Dis Esophagus 2003;16:73-6.
12. Stanghellini, V, Armstrong D, Mönnikes H, Bardhan KD. Systematic review: do we need a new gastro-oesophageal reflux disease questionnaire? Digestion 2007;75:3-16.
13. Liker H, Hungin P, Wiklund, I. Managing gastroesophageal reflux disease in primary care: the patient perspective. J Am Board Fam Pract 2005;18:393-400.
14. Smith MS, Doroshow C, Womack WM, et al. Symptomatic mitral valve prolapse in children and adolescents: catecholamines, anxiety, and biofeedback. Pediatrics 1989;84:290-5.