CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 1, January/February 2013
122
AFRICA
T1DM (16
±
2.2 yrs) and 28 ALL patients (14
±
3.4 yrs) matched
with 12 healthy controls (HC) (16
±
1.7 yrs). Endo-PAT recorder was
used for the determination of RHI and specific biochemical markers
of EF were assessed (hsCRP, ADMA, E-selectin, VCAM). RHI was
evaluated in T1DM and ALL children and compared with HC. In
addition, RHI was correlated with anthropometric and biochemical
parameters.
Results
: Significantly lower RHI were revealed in T1DM and ALL
patients in comparison with HC (1.44
±
0.41, 1,57
±
0.50 and 1.99
±
0.68;
p
≤
0.05 respectively) implying impaired endothelial-dependent
dilation. No association was revealed between RHI and anthropomet-
ric parameters, arterial blood pressure or glycated haemoglobin in
both T1DM and ALL groups.
Conclusions:
Our results support the hypothesis of impaired EF in
T1DM children which is in agreement with previously published data
in adults. Our study also showed impaired EF in ALL patients. We
believe that a non-invasive method such as RHI is a promising future
prospect for EF assessment in children with high risk of PMA and
may aid tailoring their treatment strategies.
This work was supported by research project MSMT CZ- No.
0021620816 and P36.
961: KEY POINTS OF CHEST PAIN IN CHILDREN AND
ADOLESCENTS
Eun Young Choi
1
, Jung Yun Choi
1
, Kyung Sook Choi
2
1
Department of Pediatrics, Seoul National University Bundang
Hospital, Seoul, Korea
2
School of Nursing, Chung-Ang University, Seoul, Korea
Objective
: Paediatric cardiologists frequently encounter chest pain
in children and adolescents. This study is performed to characterise
the common complaint and to emphasise the significance of the
symptom.
Methods
: The medical records of children and adolescents under
19 years old who presented to Seoul National University Bundang
Hospital, Gyeonggi-do, Korea between 10 May 2003 and 30 June
2012 with a complaint of chest pain were reviewed retrospectively.
Results
: Data of 479 patients were reviewed. The proportion of males
to females was 1.52 (289 males and 190 females) and the median age
was 9.16 years old (range: 2.44–18.79 years). Cardiac causes of chest
pain were decided in only 4 cases (0.8%). The remaining 475 patients
had chest pain of unknown (264), musculoskeletal (155), psychiatric-
related (28), pulmonary (14) or gastrointestinal (12) origin. During
the follow-up period, only 34 patients (7.1%) had medication or
interventional procedures. Interestingly, 89.4% (428) had no more
anxiety about chest pain after reassurance from a doctor; however 49
patients (10.2%) still suffered from sustained chest pain, headache,
abdominal pain and so on. There were no deaths during follow-up
and 2 patients were diagnosed with breast mass.
Conclusion
: Chest pain in children and adolescents is a very
common problem but it rarely has a cardiac cause. However, in 10%
of patients the problem remained unsolved. Although it is not a life-
threatening condition as in adults, more meticulous history taking
and a careful approach is needed.
1072: TRANSITION ‘READINESS’AMONGYOUNG ADULTS
WITH CONGENITAL HEART DISEASE
Andrew Mackie
1,2
, Gwen Rempel
3
, Joyce Magill-Evans
4
, Kathryn
Rankin
1
, Cheri Robert
1
, David Nicholas
5
, Adrienne Kovacs
6
1
Department of Pediatrics, University of Alberta, Edmonton, Canada
2
Division of Cardiology, Stollery Children’s Hospital, Edmonton,
Canada
3
Faculty of Nursing, University of Alberta, Edmonton, Canada
4
Faculty of RehabilitationMedicine, University ofAlberta, Edmonton,
Canada
5
Division of Social Work, University of Calgary, Canada
6
Peter Munk Cardiac Centre, University Health Network, Toronto,
Canada
Background
: Given the lifelong nature of congenital heart disease
(CHD), adolescents and young adults with CHD are expected to
assume increasing responsibility for their health care management
independent of their parents/guardians. The Transition Readiness
Assessment Questionnaire (TRAQ) is a 29-item questionnaire with
two domains (self-management, self-advocacy) designed to measure
transition ‘readiness’ among adolescents and young adults with
chronic health conditions. The TRAQ has not previously been evalu-
ated in the CHD population. We investigated whether TRAQ scores
differed by age, defect complexity (moderate vs great), and/or clinic
in which patients are followed (paediatric vs adult).
Methods
: Cross-sectional study of 18–25-year-olds with moderate or
complex CHD managed in Edmonton or Toronto, Canada. Subjects
completed the TRAQ following a CHD clinic visit. TRAQ scores
have a range of 1–5, with higher scores reflecting greater independ-
ence.
Results
: Of 128 patients, 80 (63%) had defects of moderate complex-
ity and 48 (37%) had defects of great complexity; 55 (43%) were
female. Self-management scores were significantly higher among
23–25-year-olds than 18–19-year-olds (4.4
±
0.6 vs 3.6
±
0.9,
p
<
0.0001). Self-advocacy scores were also higher among 23–25-year-
olds compared to 18–19-year-olds (4.6
±
0.5 vs 4.0
±
0.7,
p
<
0.0001). Neither self-management scores nor self-advocacy scores
differed significantly between patients with defects of moderate vs
great complexity or between patients followed in paediatric vs adult
CHD clinics.
Conclusions
: Among young adults with CHD, transition readi-
ness does not appear to be influenced by the severity of the CHD
lesion or whether patients are followed in a paediatric vs adult CHD
clinic. What is apparent, however, is that self-management and self-
advocacy both improve with increasing age. This is consistent with
the notion of a ‘successful’ transition process in which young people
with CHD gradually assume increasing responsibility for their health
care.
1078: COMMITTED TO LIFE: ADOLESCENTS AND YOUNG
ADULTS’ EXPERIENCES OF LIVING WITH FONTAN
CIRCULATION
Malin Berghammer
1
, Eva Brink
1
, Annika Rydberg
2
, Mikael Dellborg
3
,
Inger Ekman
1,
4
1
Institute of Health and Cardiology, Sahlgrenska Academy, University
of Gothenburg, Sweden
2
Department of Clinical Sciences, Pediatrics, University of Ume,
Sweden
3
Institute of Medicine, Sahlgrenska Academy, University of
Gothenburg, Sweden
4
Centre for Person-Centred Care, University of Gothenburg, Sweden
Background
: Single-ventricle defects are among the most complex
congenital heart defects and the development of advanced surgi-
cal procedures in the last decade has created the first generation of
adolescents and young adults living with this condition. Yet little is
known about how these individuals experience life and what impact
the heart defect has on their life in general.
Aim
: The aim was to illuminate and gain a deeper understanding of
adolescents’ and young adults’ experiences of living with a surgically
palliated univentricular heart.
Method
: All adolescents and young adults operated before 1995
according to the Fontan or the total cavo-pulmonary connection
procedure, at one paediatric cardiology unit were included in the
study. They were 17–32 years of age (mean age 22 years). Seven
open-ended in-depth interviews were conducted, transcribed and
analysed according to the phenomenological hermeneutical method.
Results
: The interpretation of the interview texts showed that the
participants experienced living with a surgically palliated univen-
tricular heart in terms of feeling exceptional, strong and healthy.
This was supported by two structural analyses, where three themes
emerged: happiness about being me, focusing on possibilities and
being committed to life.
