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Electrocardiographic and echocardiographic findings in street children known to be substance abusers

Published online by Cambridge University Press:  20 December 2007

Seref Olgar*
Affiliation:
Department of Pediatric Cardiology, Istanbul University – Faculty of Medicine, Capa, Istanbul, Turkey
Aygun Dindar
Affiliation:
Department of Pediatric Cardiology, Istanbul University – Faculty of Medicine, Capa, Istanbul, Turkey
Turkan Ertugrul
Affiliation:
Department of Pediatric Cardiology, Istanbul University – Faculty of Medicine, Capa, Istanbul, Turkey
Rukiye Eker Omeroglu
Affiliation:
Department of Pediatric Cardiology, Istanbul University – Faculty of Medicine, Capa, Istanbul, Turkey
Umrah Aydogan
Affiliation:
Department of Pediatric Cardiology, Istanbul University – Faculty of Medicine, Capa, Istanbul, Turkey
*
Correspondence to: Seref Olgar, MD, Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Cardiology, 34390 Capa, Istanbul, TURKEY. Tel & Fax: +90 246 227 46 64; E-mail: erefolgar@yahoo.com or solgar@hacettepe.edu.tr

Abstract

Substance abuse is prevalent in adolescent street children, and death is reported as secondary to aspiration, accidental trauma, asphyxia, cardiac arrhythmia, anoxia, vagal inhibition and respiratory depression. In this study, we examined electrocardiographic and echocardiographic findings from 53 street male adolescents, comparing our findings to those obtained from 61 controls in the same age group. The street children smoked cigarettes (98.1%) and had used, or were using, thinner (73.6%), glue (75.5%), hashish (79.2%), morphine or its products (24.5%), ecstasy (37.7%), anti-emetics (13.2%) and alcohol (60.4%). On examination, their blood pressures were lower than the control group. Electrocardiographically, PR, QRS, QT were found to be longer (p less than 0.05) than the values for healthy controls. Although it was not statistically significant, QTc duration was also longer than the control group. Echocardiography revealed increased diameters of the left ventricle and atrium, the aorta, and the coronary arteries as compared to the healthy children (p less than 0.05).

Type
Original Article
Copyright
Copyright © Cambridge University Press 2008

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References

1. Anderson, HR, Macnair, RS, Ramsey, JD. Deaths from abuse of volatile substances: a national epidemiological study. Br Med J (Clin Res Ed) 1985; 290: 304307.CrossRefGoogle ScholarPubMed
2. Anderson, CE, Loomis, GA. Recognition and prevention of inhalant abuse. Am Fam Physician 2003; 68: 869874.Google ScholarPubMed
3. Garson, A. How to measure the QT interval – what is normal. Am J Cardiol 1993; 72: 14B.CrossRefGoogle Scholar
4. Watson, JM. Solvent abuse by children and young adults: a review. Br J Addict 1980; 75: 2736.CrossRefGoogle Scholar
5. Meadows, R, Verghese, A. Medical complications of glue sniffing. South Med J 1996; 89: 455462.CrossRefGoogle ScholarPubMed
6. Uzun, N, Kendirli, Y. Clinical, socio-demographic, neurophysiological and neuropsychiatric evaluation of children with volatile substance addiction. Child Care Health Dev 2005; 31: 425432.CrossRefGoogle ScholarPubMed
7. Ramsey, J, Anderson, HR, Bloor, K, Flanagan, RJ. An introduction to the practice, prevalence and chemical toxicology of volatile substance abuse. Hum Toxicol 1989; 8: 261269.CrossRefGoogle Scholar
8. Esmail, A, Warburton, B, Bland, JM, Anderson, HR, Ramsey, J. Regional variations in deaths from volatile solvent abuse in Great Britain. Addiction 1997; 92: 17651771.CrossRefGoogle ScholarPubMed
9. de Carvalho, FT, Neiva-Silva, L, Ramos, MC, et al. . Sexual and drug use risk behaviors among children and youth in street circumstances in Porto Alegre. Brazil AIDS Behav 2006; 10: S57S66.CrossRefGoogle ScholarPubMed
10. Lolin, Y. Chronic neurological toxicity associated with exposure to volatile substances. Hum Toxicol 1989; 8: 293300.CrossRefGoogle ScholarPubMed
11. Viccellio, P. Abuse of volatile substances. In: Bania, T, Brent, J, Hoffman, RS, Kulig, KW, Mofenson, HC, Osborn, HH, Wang, RY, Wax, PM (eds). Emergency Toxicology 1998. Lippincott-Raven, Philadelphia, 1998, pp 925932.Google Scholar
12. Langrod, JG. Volatile substances. In: Lowison, JH, Ruiz, P, Millman, RB, Langrod, JG (eds). Substance abuse: a comprehensive textbook 1992. Williams & Wilkins, Baltimore, 1992, pp 303327.Google Scholar
13. Cunningham, SR, Dalzell, GW, McGirr, P, Khan, MM. Myocardial infarction and primary ventricular fibrillation after glue sniffing. Br Med J (Clin Res Ed) 1987; 294: 739740.CrossRefGoogle ScholarPubMed
14. Straus, SMJM, Kors, JA, De Bruin, ML, et al. . Prolonged QTc interval and risk of sudden cardiac death in a population of older adults. J Am Coll Cardiol 2006; 47: 362367.CrossRefGoogle Scholar
15. Downes, MA, Whyte, IM, Isbister, GK. QTc abnormalities in deliberate self-poisoning with. Moclobemide Intern Med J 2005; 35: 388391.CrossRefGoogle ScholarPubMed
16. Lorsheyd, A, de Lange, DW, Hijmering, ML, Cramer, MJ, van de Wiel, A. PR and QTc interval prolongation on the electrocardiogram after binge drinking in healthy individuals. Neth J Med 2005; 63: 5963.Google ScholarPubMed
17. Fitzgerald, JL, Reid, JJ. Sympathomimetic actions of methylenedioxymethamphetamine in rat and rabbit isolated cardiovascular tissues. J Pharm Pharmacol 1994; 46: 826832.CrossRefGoogle ScholarPubMed
18. Krantz, MJ, Lewkowiez, L, Hays, H, Woodroffe, MA, Robertson, AD, Mehler, PS. Torsade de pointes associated with very-high-dose methadone. Ann Intern Med 2002; 137: 501504.CrossRefGoogle ScholarPubMed
19. Martell, BA, Arnsten, JH, Ray, B, Gourevitch, MN. The impact of methadone induction on cardiac conduction in opiate users. Ann Intern Med 2003; 139: 154155.CrossRefGoogle ScholarPubMed
20. Sticherling, C, Schaer, BA, Ammann, P, Maeder, M, Osswald, S. Methadone-induced Torsade de pointes tachycardias. Swiss Med Wkly 2005; 135: 282285.Google ScholarPubMed
21. Singh, N, Singh, HK, Singh, PP, Khan, IA. Cocaine-induced torsades de pointes in idiopathic long Q-T syndrome. Am J Ther 2001; 8: 299302.CrossRefGoogle ScholarPubMed
22. Zareba, W, Moss, AJ, Schwartz, PJ, et al. . Influence of genotype on the clinical course of the long-QT syndrome. International Long-QT Syndrome Registry Research Group. N Engl J Med 1998; 339: 960965.CrossRefGoogle ScholarPubMed
23. Garson, A Jr, Dick, M 2nd, Fournier, A, et al. . The long QT syndrome in children. An international study of 287 patients. Circulation 1993; 87: 18661872.CrossRefGoogle Scholar