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Original ArticleOpen Access
Early Detection of Cardiac Involvement in Beta-Thalassemia Children
Durongpisitkul K 
,
Kruasukon S ,
Kangkagate C ,
Tanphaichitr VS
,
Kruasukon S ,
Kangkagate C ,
Tanphaichitr VS Background : Beta-thalassemia major and beta-thalassemia/HbE are the important causes
of chronic hemolytic anemia in Thailand. The objectives of the study were to determine variables
associated with cardiac involvement in asymptomatic beta-thalassemia patients.
Patients and Method : The authors studied beta-thalassemia major and beta-thalassemia/
HbE patients who came to the clinic between July 1'' 1999 and July 31" 2000. There were 211
asymptomatic patients included in study. Their ages ranged from 2.6 to 18.2 years. Previous clinical
history including blood transfusion and iron chelation were recorded. All patients received a thorough
physical examination, chest X-ray, electrocardiogram and echocardiogram. Patients who had abnormal
systolic or diastolic function detected by echocardiogram were identified as having cardiac involve-
ment.
Results :Cardiac involvement was found in 26 patients (12.3%). There was no difference
in physical examination between patients who had and did not have cardiac involvement. Abnormal
chest X-Ray defined as cardiothoracic (CT) ratio>0.55 and electrocardiogram (ECG) findings of
left or right ventricular hypertrophy were associated with cardiac involvement. Other associated
findings were older age and lower average pretransfusion hematocrit (23
เธ‘
6.6% ).
Conclusions : In asymptomatic beta-thalassemia children, chest X-ray and ECG should be
used for screening patients for the detection of cardiac involvement.
Key word : Beta-Thalassemia, Cardiac Involvement, Children, Thailand
of chronic hemolytic anemia in Thailand. The objectives of the study were to determine variables
associated with cardiac involvement in asymptomatic beta-thalassemia patients.
Patients and Method : The authors studied beta-thalassemia major and beta-thalassemia/
HbE patients who came to the clinic between July 1'' 1999 and July 31" 2000. There were 211
asymptomatic patients included in study. Their ages ranged from 2.6 to 18.2 years. Previous clinical
history including blood transfusion and iron chelation were recorded. All patients received a thorough
physical examination, chest X-ray, electrocardiogram and echocardiogram. Patients who had abnormal
systolic or diastolic function detected by echocardiogram were identified as having cardiac involve-
ment.
Results :Cardiac involvement was found in 26 patients (12.3%). There was no difference
in physical examination between patients who had and did not have cardiac involvement. Abnormal
chest X-Ray defined as cardiothoracic (CT) ratio>0.55 and electrocardiogram (ECG) findings of
left or right ventricular hypertrophy were associated with cardiac involvement. Other associated
findings were older age and lower average pretransfusion hematocrit (23
เธ‘
6.6% ).
Conclusions : In asymptomatic beta-thalassemia children, chest X-ray and ECG should be
used for screening patients for the detection of cardiac involvement.
Key word : Beta-Thalassemia, Cardiac Involvement, Children, Thailand
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