Postural tachycardia in children and adolescents with joint hypermobility syndrome

DOI: https://doi.org/10.29296/25877305-2020-01-13
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Issue: 
1
Year: 
2020

Professor V. Delyagin(1), MD; N. Aksenova(2) (1)Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, Moscow (2)City Children’s Polyclinic One Hundred and Fifty, Moscow Healthcare Department

Joint hypermobility syndrome (JHS) is perhaps the most common type of connective tissue dysplasia, which frequently occurs with systemic disorders. Postural tachycardia is considered as one of the manifestations of this syndrome. But the clinical interpretation of postural tachycardia requires clarification. Material and methods. We examined 26 children with JHS without a history of syncope (group 1; 11 boys and 15 girls, age 14.27±0.27 years) and 26 children without a history of JHS (group 2; 12 boys and 14 girls, age 14.19±0.25 years). We separately assessed the dynamics of heart rate in 12 children with JHS and orthostatic syncope(3 boys and 9 girls, age 14.21±0.28 years). Heart rate was determined at a 10-minute horizontal position and immediately after verticalization. JHS was diagnosed according to the criteria of R. Graham et al., M. Simpson, with a score of 4 or higher with other signs of GHS: family history, age, gender, mitral valve prolapse, myopia, skin hyperelasticity, marfanoid status. Results. Groups 1 and 2 by gender and age did not differ. The average age of children in the group with a history of syncope also did not differ from groups 1 and 2, but girls prevailed. Heart rate at rest in all groups was statistically insignificant. However, heart rate after verticalization, in the group with JHS without fainting (90.22±2.67) and with fainting (108.19±8.19), significantly (p≤0.0002) exceeded the similar indicators (70.23±1,17) in the control group. Conclusion. In children with JHS, heart rate increased sharply during verticalization, especially in those prone to fainting, which may indicate autonomic dysfunction inherent in connective tissue dysplasia.
Keywords: 
children
connective tissue
tachycardia
autonomic nervous system

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