Study On The Cardiac Causes For Chest Pains Nursing Essay

Study On The Cardiac Causes For Chest song Nursing EssayThe relation of thorax hurtings with cardiac causes obligated for the botheration was one targeted area for studies. From the precedent researches government agency of drawers trouble oneself was find to be one common complaints in children and anterior findings inform it to be more(prenominal) prominent in old advances with mean age of 13 and cardiac causes was responsible for less than 20% of chest distressingness complaints in younger children and in community which was supposed to exist because of ischemic good dysfunction, myocardial and pericardial inflammatory process or arrhythmia entirely exact cause for cardiac chest hurt was dormant in dark. Specialised methods like echocardiography, Holter monitoring, excercise stress test, electrophysiological studies were reported to be call for to appreciate cardiac ailments in children responsible for chest pain but still it may non be able to give exact c auses of chest pain. The purpose for this development was to list cardiac diseases and to explore cardiac causes which were this instant associated with chest pain in children.(Cagdas and Pac, 2009)MethodsIn this study one hundred twenty children with ages in mingled with 5-16 long time who were frequently reported to pediatric cardiology clinic regarding chest pain were analysed in a tertiary subspecialty clinic from March 2005 to May 2006. The reason for selecting children with ages 5-16 eld having chest pain complains was based on previous findings of studies and was good natural selection of selection for assessment of cardiac diseases cerebrate to chest pain as it was targeted company for chest pain and further in this study it was divided in two age classifys that was 5-12 age age theme and 13-16 years age group because of psychogenic pain consideration in children older than 12 years age which was good reasoning for dividing groups. Thus it was cross-sectional and a retrospective assessment but as it relies on previous findings and data from other clinics it might afford limitations in selection and numerate selected that was 120 subjects let onms to be very less for this subject of assessment therefrom it might lead in error.(Cagdas and Pac, 2009)The strength of this study was dependent on the outcomes of methods used for analysis of cardiac diseases associated with chest pain. All selected patients were subjected to Echocardiography, Electrocardiography(cardiogram) and Chest roentgenogram and analysis of Hemogram, serum glucose and electrolytes was done. In Chest X-Ray all necessary images to diagnose meat, lung, chest wall and big vessels are generated by ionising irradiation in X-ray form (P.A.Mahesh, 2006). In Electrocardiography functioning of diametrical parts of sprightliness muscles are measured by recording in skin electrodes placed on different positions of heart and it displays in ECG as electrical signal. The displa y of ECG shows rhythm of heart and detriment of any heart muscles depose be reason out(Meek and Morris, 2002). Echocardiogram generates two-dimensional pictures using sonography techniques for cardiovascular systems. In Echocardiography echoes of sound waves are picked by transducer and are genetical as electrical impulses which are then converted to motion pictures of heart by Echocardiography machine and also movement of blood via heart is save by Doppler probe. Different types of cardiac diseases can be identified by this methods.(Quinones et al., 2003)Also excercise and debate get across test and twenty four instant Holter monitoring was carried out in some required cases which also gave enlarge regarding cardiac diseases. In 24 hour Holter monitoring test for 24 hour an electrodes are attached on chest of the subject to be monitored by which electrical activity of heart is recorded to an attached lessened battery operated monitor. Note of all activities carried out b y patient during 24 hours is required and results after 24 hour of test are analysed to see any irregular changes in rhythm of heart and for further analyses of cardiac disease (Hilbel et al., 2008). Different ways are developed to perform tilt table depending on individual patient generally patient is blockade to any material movement of body and kept flat on tilt table and it is then suspended or tilted at different angles. Records of symptoms, blood pressure, pulse, electrocardiogram etc are kept during test which can be use for analysis of cardiac disease(Benditt et al., 1996).Actually this study was knowing and conducted on algorithm setup in which depending on types of symptoms observed from corporeal interrogative sentence and narration of patients it was further evaluated using different methods to identify cardiac causes.(Cagdas and Pac, 2009)SPSS 11.0(SPSS, Inc., Chicago, IL, USA) software was use to carry out statistical assessment in which Chi-square test was selec ted for analyses of difference in variables of groups in which substantive level p value was kept less than 0.05 and stake between groups was compared by betting odds ratio value(95% Confidence Interval). Here the total number of patients was 120 which is kind of large thus selection of Chi-square test to analyse difference in variables of two groups was perfect.(Cagdas and Pac, 2009)ResultsIn this study out of 120 patients depending on history and physical examination evaluation of further detail assessment by performing stated techniques as required 52(42.5%) patients were found to have cardiac diseases out of which 11(9.2%) patients on admission were found to have history of cardiac disease and in 28(23.3%) patients chest pain was supposed to be in a flash associated with cardiac disease and out of 28 patients 14(11.6%) were reported with different types of arrhythmias as shown in table 2.(Cagdas and Pac, 2009)On complete assessment of all patients for cardiac disease accordi ng to the age group that is 5-12 years of age and 12-16 years of age the children were analysed with structural Cardiac Disease and types of arrhythmia as shown in table 1 and 2.(Cagdas and Pac, 2009)Different types of Cardiac diseases found to be associated with chest pain is also listed in table 1 and 2. In table 2 patients with infrequent supraventricular ectopy and ventricular ectopy were excluded.(Cagdas and Pac, 2009)Table.1. SPSS result for frequency and happen of structural cardiac disease according with age in patients with chest pain(Cagdas and Pac, 2009)Groupsgeomorphologic Cardiac DiseasepPresent missingTypeNTotal,n(%)Total,n(%)5-12 years old (n=55)RVHD511(20)44(80)0.011MVP3CMP1ASD1PFO113-16 years old (n=65)RVHD1227(41.5)38(58.5)MVP4CMP3VSD3AS3ASD1PFO1Chi-square test, essay analysis, reference book group is taken as 5-12 years age groupAS- valcular aortic stenosis, ASD- atrial septel defect, CMP- cardiomyopathy, MVP- mitral valve prolapse, PFO- patent foramen ovale, RVHD- rheumatic valvular heart disease, VSD- ventricular septal defectRef CAGDAS, D. N. PAC, F. A. (2009) Cardiac chest pain in children. Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 9, 401-406.As shown in above SPSS result the find of structural cardiac disease in old age group was 2.84 clock gamyer as compared to younger age group and significant p value was 0.011 which was less than 0.05 which states that there was significant difference between variables of two age groups with structural cardiac disease.(Cagdas and Pac, 2009)Table.2. SPSS result for Frequency and risk of arrhythmia with age in patients with chest pain(Cagdas and Pac, 2009)GroupsArrhythmiasPPresentAbsentTypeNTotal,n(%)Total,n(%)5-12 years old (n=55)Frequent VE and SVE33 (5.5)52 (94.5)0.0513-16 years old (n=65)Frequent VE and SVE711 (16.9)54 (83.1)WPW Syndrome2Sinus bradycardia1Sinus pause1Chi-square test, Risk analysis, Reference group is taken as 5-12 age groupSVE supraventricular ecto py, VE ventricular ectopy, WPW Wolff-Parkinson-White syndromeRef CAGDAS, D. N. PAC, F. A. (2009) Cardiac chest pain in children. Anadolu Kardiyoloji Dergisi-the Anatolian Journal of Cardiology, 9, 401-406.As shown in above SPSS result the risk of arrhythmias in older age group was 3.53 times higher as compared to younger age group and significant p value was 0.05 which shows borderline significant difference in variables of two groups with arrhythmias.(Cagdas and Pac, 2009)Overall analysis of arrhythmias and structural cardiac disease reported 4.12 times higher risk of cardiac disease in senior age group (12-13 years age) as compared to that with younger age group (5-12 years age).(Cagdas and Pac, 2009)DiscussionThe results of this study was compared with other studies and different required methods were performed for analyses of cardiac disease think to chest pain which was not performed in previous studies. In previous findings majority of patients were assessed by only echoc ardiography without performing 24 hour holter monitor test to any patients while in this study echocardiography was performed to all children and holter monitoring was done for 38(31.6%) patients out of 120 as required and also frequencies of arrhythmias was found to be 11.6% and same ratio for structural cardiac disease which as compared to other studies was high. Thus use of various methods for assessing cardiac diseases associated with chest pain was good effort made in this study.(Cagdas and Pac, 2009) wizard finding of this study was that chest pain complains was more in the elder children which was supported by previous epidemiological studies for the chest pain complaints. cardiopulmonary problems in young children and psychogenic pain in children older than 12 years of age was reported from previous studies while from this study 4.12 times more risk to cardiac disease was found in elder age group on analysing all cardiac diseases and was explained because of aging related ri sk of arrhythmias or increase in structural cardiac diseases symptoms or increase in level of consciousness with increasing age regarding cardiac chest pain symptoms which was satisfactory reasoning given in this study. From the SPSS results it think that older children were at high risk to structural cardiac disease (p=0.011) and 3.53 times more frequent to arrhythmias. Thus use of SPSS results in analyses of cardiac disease was one very important part of this study as it explored some critical and different results compared to other studies.(Cagdas and Pac, 2009)In 28(23.3%) patients chest pain was supposed to be directly caused by cardiac diseases and which was assumed because of high frequency of some cardiac diseases in patients selected but clear reasons for chest pain was still not proved. From previous studies majority of non-cardiac chest pain was reported because of gastro-esophageal reflux diseases and in this study total 40 patients were execrable chest pain because of similar reasons like abdominal pain, epigastric tenderheartedness etc which highlighted one important conclusion that their may exist more than one cause for chest pain not necessary that its always related to cardiac disease. This study also gave example of important application of echocardiography in diagnosis of rheumatic valvular heart disease as it was observe in 17 children as compared to analyses done by clinical examination for existence of rheumatic valvular heart disease.(Cagdas and Pac, 2009)In this study pursual the particular algorithm the study groups were analysed from which many results reported was different from that concluded by physical examination like in 16 patients physical examination showed it to be innocent murmur but was found to have structural cardiac disease on further analyses. Thus though this type of algorithm requires some extra excercise but it made analyses to identify cardiac disease more clear.(Cagdas and Pac, 2009)Overall this study conclud ed that risk of cardiac disease was increased with age and it also gave percentage of cardiac disease that was 42.5% which was high as compared to other studies. The study also highlighted importance and use of different methods that can be used for detail analyses of cardiac disease that was not covered in previously performed studies but this type of evaluation was to be carried out with larger number of patients to get more clear with results and draw important conclusion because by analysing only 120 children with chest pain one common conclusion can not be given. Selection of proper SPSS tests was done which gave important results for this study. This study assay very well to identify cardiac diseases causing chest pain with all good planning and reasoning behind all steps and methods used but still research in area of cardiac diseases will not be clear unless any sure and precise result for particular cardiac disease can be taken as reference to identify and to draw conclu sion.