7. Đặc điểm điện tâm đồ của trẻ mắc bệnh tim bẩm sinh động mạch vành trái xuất phát từ động mạch phổi

Abstract

The study aimed to describe the electrocardiographic characteristics of children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) at the Vietnam National Children’s Hospital from January 2016 to May 2025. The mean age of the 62 patients in the study was 5 ± 4.5 months old, of which 96.8% were diagnosed before 12 months of age. Echocardiography recorded 53 children with markedly dilated left heart chambers (85.5%). Severe left ventricular systolic dysfunction with ejection fraction ≤ 40% was high at 77.4%. Abnormal T-wave inversion was observed in 57 patients (91.9%), most frequently in lead aVL (75.8%), followed by leads I and V5–V6 with similar rates (67.7%). Pathological Q waves were present in 85.5% of patients, most commonly in the anterolateral leads aVL (79%), followed by I (45.2%) and V5–V6 (32.3%). Q-wave depth in aVL and V5–V6 was significantly greater in the group with LVEF ≤ 40% (p < 0.05). After surgery, electrocardiographic abnormalities tended to improve. Thus, ALCAPA is often diagnosed in children under 12 months of age. Common electrocardiographic lesions included signs of myocardial infarction, myocardial ischemia, and repolarization abnormalities in the anterolateral wall of the left ventricle.