Bross U, Brüggemann G, Schmaltz A A
Monatsschr Kinderheilkd. 1985 Jul;133(7):476-82.
Out of 9557 children we found 120 children (1,26%), who showed deep Q-waves of greater than or equal to 0.4 mV in 3 consecutive ECG's at least in one of the leads I, aVL, V4, V5 and V6. 70 children were investigated additionally by echocardiography, 45 by vectorcardiography according to Frank. Echocardiography revealed an increased septal thickness in 5 patients, a borderline thickness in 8, an increased septal/posterior wall ratio in 4. In the vectorcardiogram 51,1% of the patients had no Q-waves in lead y, mostly in combination with deep Q-waves in a VL or left axis deviation. Q-waves in lead y were combined with Q-waves in V 5/6. The determination of the main axis coincided in 80% of ECG and VCG. Looking for the various heart diseases, 30% of the children with Q-waves had a ventricular septal defect, 23,3% an endocardial cushion defect, 10,8% a patent ductus arteriosus, 3,3% a bradycardia, 2,5% a Bland-White-Garland syndrome and 1,6% a hypertrophic cardiomyopathy. 17,5% of the children had an innocent heart murmur, 5,8% no cardiac symptoms. Other diseases were found in 5%. The most frequent cause of Q-waves in children were volume-overload of the left ventricle (35%) and left axis deviation (33,3%), whereas myocardial infarction and septal hypertrophy (3,3 and 4,1%) were of minor importance. In healthy children (23,3%) we could not find any pathomechanism.
在9557名儿童中，我们发现120名儿童（1.26%）至少在I、aVL、V4、V5和V6导联中的一个导联上，连续3次心电图显示深Q波，其幅度大于或等于0.4mV。另外对70名儿童进行了超声心动图检查，45名儿童按照弗兰克法进行了向量心电图检查。超声心动图显示5例患者室间隔厚度增加，8例临界厚度，4例室间隔/后壁比率增加。在向量心电图中，51.1%的患者y导联无Q波，大多与aVL导联深Q波或左轴偏移同时出现。y导联Q波与V5/6导联Q波同时出现。80%的心电图和向量心电图的电轴测定结果一致。在寻找各种心脏病时，有Q波的儿童中30%患有室间隔缺损，23.3%患有心内膜垫缺损，10.8%患有动脉导管未闭，3.3%患有心动过缓，2.5%患有布兰德-怀特-加兰综合征，1.6%患有肥厚型心肌病。17.5%的儿童有生理性心脏杂音，5.8%无心脏症状。5%的儿童发现有其他疾病。儿童出现Q波最常见的原因是左心室容量负荷过重（35%）和左轴偏移（33.3%），而心肌梗死和室间隔肥厚（分别为3.3%和4.1%）则不太重要。在健康儿童（23.3%）中，我们未发现任何病理机制。
