[Exercise hypertension in children after surgical repair of treated ventricular and atrial septal defects].

The blood pressure profile during exercise of children who have undergone surgery for left-to-right intracardiac shunt is not well documented. The aim of this study was to measure the peak blood pressure during dynamic exercise stress testing in children operated on for atrial or ventricular septal defects and to compare the results with those of normal children and children operated on for tetralogy of Fallot. Forty eight cases of atrial septal defect, 53 cases of ventricular septal defect and 33 cases of tetralogy of Fallot aged 5 to 14 years underwent maximal exercise stress testing on a treadmill using a modified Bruce protocol, one to ten years after the surgical repair. The heart rate, blood pressure and electrocardiogram were recorded. The duration of the test was used to judge effort tolerance. In order to compare children of different ages and sizes, the relative values were calculated using the following formula: patient value minus the mean value of the control group of the same age divided by the standard deviation of this group. At rest before exercise, there was no difference between the blood pressure of patients operated on for a left-to-right shunt and of the control group of normal children. However, the maximum systolic blood pressure during exercise was higher in patients who had undergone surgery for a left-to-right shunt than in the controls. The differences were only 0.42 standard deviations in ventricular septal defects and 0.61 standard deviations in atrial septal defects, but they were statistically significant (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)