Lack of Association of ST–T Wave Abnormalities to Congenital Heart Disease in Neonates

Sudheer R. Gorla, Daphne T. Hsu, Aparna Kulkarni

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: ST–T wave (STTW) abnormalities have been described in 20–40% of normal newborns. We sought to describe the associations of these Electrocardiogram (ECG) abnormalities to perinatal course and congenital heart disease (CHD). Methods: A retrospective chart review was performed on all neonatal ECGs between January 2008 and March 2013 identified from electronic medical records. Electronic medical records were reviewed for perinatal course and maternal medical conditions. Neonates <37 weeks gestation, >3 days age, requiring hemodynamic support in the first 3 days, with oxygen saturation <90% on room air, or with arrhythmias and significant abnormalities of axis and voltage were excluded from the analysis. ST segment elevation or depression of >2 mm in at least one lead and flat or inverted T waves in at least one lead except aVR were considered abnormal. Statistical relationships were explored between STTW abnormalities, perinatal variables and CHD. Results: ECGs were performed on 1043 neonates, of which 664 were included. STTW abnormalities were found in 236 (35.5%) neonates. T wave abnormalities were identified in 191 (28.7%), ST segment abnormalities in 77 (11.6%) and both on 32 (4.8%) neonates. No relationship was found between the ECG abnormalities and perinatal variables, except maternal cefazolin administration during labor. Noncritical CHD was diagnosed by echocardiography in 59/84; STTW abnormalities were seen in 17/59 (29%) patients with and 9/25 (34%) without noncritical CHD, P =.6. Conclusion: STTW abnormalities on ECG are commonly found in 35.5% of normal neonates and do not predict noncritical CHD.

Original languageEnglish (US)
Pages (from-to)403-408
Number of pages6
JournalCongenital Heart Disease
Volume11
Issue number5
DOIs
StatePublished - Sep 1 2016

Fingerprint

Heart Diseases
Newborn Infant
Electrocardiography
Electronic Health Records
Mothers
Cefazolin
Echocardiography
Hemodynamics
Oxygen
Lead

Keywords

  • Congenital Heart Disease
  • Electrocardiogram
  • Neonates
  • ST-T Wave Abnormalities

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Lack of Association of ST–T Wave Abnormalities to Congenital Heart Disease in Neonates. / Gorla, Sudheer R.; Hsu, Daphne T.; Kulkarni, Aparna.

In: Congenital Heart Disease, Vol. 11, No. 5, 01.09.2016, p. 403-408.

Research output: Contribution to journalArticle

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abstract = "Background: ST–T wave (STTW) abnormalities have been described in 20–40{\%} of normal newborns. We sought to describe the associations of these Electrocardiogram (ECG) abnormalities to perinatal course and congenital heart disease (CHD). Methods: A retrospective chart review was performed on all neonatal ECGs between January 2008 and March 2013 identified from electronic medical records. Electronic medical records were reviewed for perinatal course and maternal medical conditions. Neonates <37 weeks gestation, >3 days age, requiring hemodynamic support in the first 3 days, with oxygen saturation <90{\%} on room air, or with arrhythmias and significant abnormalities of axis and voltage were excluded from the analysis. ST segment elevation or depression of >2 mm in at least one lead and flat or inverted T waves in at least one lead except aVR were considered abnormal. Statistical relationships were explored between STTW abnormalities, perinatal variables and CHD. Results: ECGs were performed on 1043 neonates, of which 664 were included. STTW abnormalities were found in 236 (35.5{\%}) neonates. T wave abnormalities were identified in 191 (28.7{\%}), ST segment abnormalities in 77 (11.6{\%}) and both on 32 (4.8{\%}) neonates. No relationship was found between the ECG abnormalities and perinatal variables, except maternal cefazolin administration during labor. Noncritical CHD was diagnosed by echocardiography in 59/84; STTW abnormalities were seen in 17/59 (29{\%}) patients with and 9/25 (34{\%}) without noncritical CHD, P =.6. Conclusion: STTW abnormalities on ECG are commonly found in 35.5{\%} of normal neonates and do not predict noncritical CHD.",
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N2 - Background: ST–T wave (STTW) abnormalities have been described in 20–40% of normal newborns. We sought to describe the associations of these Electrocardiogram (ECG) abnormalities to perinatal course and congenital heart disease (CHD). Methods: A retrospective chart review was performed on all neonatal ECGs between January 2008 and March 2013 identified from electronic medical records. Electronic medical records were reviewed for perinatal course and maternal medical conditions. Neonates <37 weeks gestation, >3 days age, requiring hemodynamic support in the first 3 days, with oxygen saturation <90% on room air, or with arrhythmias and significant abnormalities of axis and voltage were excluded from the analysis. ST segment elevation or depression of >2 mm in at least one lead and flat or inverted T waves in at least one lead except aVR were considered abnormal. Statistical relationships were explored between STTW abnormalities, perinatal variables and CHD. Results: ECGs were performed on 1043 neonates, of which 664 were included. STTW abnormalities were found in 236 (35.5%) neonates. T wave abnormalities were identified in 191 (28.7%), ST segment abnormalities in 77 (11.6%) and both on 32 (4.8%) neonates. No relationship was found between the ECG abnormalities and perinatal variables, except maternal cefazolin administration during labor. Noncritical CHD was diagnosed by echocardiography in 59/84; STTW abnormalities were seen in 17/59 (29%) patients with and 9/25 (34%) without noncritical CHD, P =.6. Conclusion: STTW abnormalities on ECG are commonly found in 35.5% of normal neonates and do not predict noncritical CHD.

AB - Background: ST–T wave (STTW) abnormalities have been described in 20–40% of normal newborns. We sought to describe the associations of these Electrocardiogram (ECG) abnormalities to perinatal course and congenital heart disease (CHD). Methods: A retrospective chart review was performed on all neonatal ECGs between January 2008 and March 2013 identified from electronic medical records. Electronic medical records were reviewed for perinatal course and maternal medical conditions. Neonates <37 weeks gestation, >3 days age, requiring hemodynamic support in the first 3 days, with oxygen saturation <90% on room air, or with arrhythmias and significant abnormalities of axis and voltage were excluded from the analysis. ST segment elevation or depression of >2 mm in at least one lead and flat or inverted T waves in at least one lead except aVR were considered abnormal. Statistical relationships were explored between STTW abnormalities, perinatal variables and CHD. Results: ECGs were performed on 1043 neonates, of which 664 were included. STTW abnormalities were found in 236 (35.5%) neonates. T wave abnormalities were identified in 191 (28.7%), ST segment abnormalities in 77 (11.6%) and both on 32 (4.8%) neonates. No relationship was found between the ECG abnormalities and perinatal variables, except maternal cefazolin administration during labor. Noncritical CHD was diagnosed by echocardiography in 59/84; STTW abnormalities were seen in 17/59 (29%) patients with and 9/25 (34%) without noncritical CHD, P =.6. Conclusion: STTW abnormalities on ECG are commonly found in 35.5% of normal neonates and do not predict noncritical CHD.

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