Assessment of Echocardiographic Changes in Malnourished Children in Saladdin General Hospital

Abstract

Malnutrition  usually  occurs  when  the  person  is  not  receiving  the  enough nutrients,  this  may  result  from  an  inadequate  or  unbalanced  food, gastrointestinal troubles and absorption difficulties ,or other medical situations. Earlier concepts that the heart is spared in malnutrition have been shown to be incorrect. Inadequate intake of protein and energy results in proportional loss of skeletal and myocardial muscle. As myocardial mass decreases, so does the ability  to  generate  cardiac  output.  while  cardiac  function  is  impaired,  the reduction is appropriate and proportional to the decrease in body surface area, which is an indicator of overall metabolic demand and cardiac function is impacted  pathologically  in  the  malnourished  child  and  decreases disproportionally to body surface area. Malnourished children suffer several alterations in body composition, with loss of heart and skeletal muscle mass, complicated by electrolyte abnormalities and mineral or vitamin deficiencies that  could  produce  cardiac  abnormalities,  including  hypotension,  cardiac arrhythmias, cardiomyopathy, cardiac failure and even sudden death.  
The total number are 100 cases,50 cases were malnourished and 50 cases were considered as control cases, Show most of study cases resident in rural 31 (62%), 19 (38%)urban, while in control 50, 35 (70%) urban and 15 (30%) rural. Regarding the time of introducing solid diet in study cases 50, most of them 31 (62%) take solid food in age 7-12months, 6 (12%) before 6 months, and 13 (26%) without solid food. But in control cases 50, most of them 41 (80%)  take  food  below  6  months,  and  only  6  (12%)  without  solid  diet. Distribution of cases according to the stroke volume in regard to the control cases. There is significant decrease in the stroke volume in the malnutrition cases 14 (28%) as compared to the control cases (0%).decrease in ejection fraction in case study 14 (28%) in compared to control group, while 35 (70%) of  study  cases  have  normal  ejection  fraction  in  compared  to  control  49 (89%).w  decrease  in  left  ventricular  volume  in  case  study  14  (28%)  in compared to control group while 35 (70%) of study cases have normal left ventricular  volume  in  compared  to  control  49  (89%).decrease  in  ejection fraction in severe type in about12(80%) and in 2(9.1%) of moderate type of malnourished children from the total number 50. decrease in stroke volume in severe type of malnutrition in about12(80%). cardiac thickness decrease in severe type in about 10(66.7%) of severe type of malnourished children.