الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
SUMMARY AND CONCLUSION
Asthma is the most common chronic illness of childhood. Almost
I in 20 children have this problem (Stockman. 1994). In. Alexandria.
Omar (1979) reported that 6.6% of children have bronchial osthma.
Morbidity associating asthma accounts for about 27 millions
patient visits and 450.000 hospital admissions per year in U.S.A.(Koren
and Bromberg. 1995). Almost 30% of the asthmatic children have
activity limitations including impaired shchool attendance (Taylor and
Newacheek.1992 ).
Asthma mortality in the U.S.A. increased during the I980s to be
about 4.000 deaths in 1988. Despite the advances in medical care. there
is evidence of increasing death rate in the 1990s (Koren and Bromberg.
1995).
Our study was conducted to throw a beam of light on the impact of
severe asthma on the heart and the possible cardiotoxic effects of
subcutaneous administration of the non-selective 13 adrenergic stimulant.
epinephrine. as an emergency room line of treatment in severe asthma
attacks.
The study included 60 children (2-10 years old). Forty of them
presented with severe asthma attacks. Twenty patients received
subcutaneous epinephrine as an emergency room line of treatment
(groupII). The other 20 patients were not in need of this line of treatment
(group I) . The remaining 20 children were chosen as healthy controls
(group III) .
All our children (patients and controls) were subjected to serum
total CPK and CPK-MB estimation as well as electrocardiographic
(ECG) examination.
In group I, 4 patients (20%) had significantly elevated total CPK
and CPK-MB. The later accounted for more than 6% of the former
denoting myocardial damage. The ECG of this group revealed the
presence of tachycardia in 45% of cases, cardiac ischemia in 15%, right
ventricular hypertrophy in 45%, left ventricular hypertrophy in 20% and
pulmonary hypertention in 20% of cases.
Total CPK as well as CPK-MB of group II are significantly higher
and higher with CPK-MB more than 6% of the total CPK in all the cases.
So, subcutaneous epinephrine increased the magnitude of myocardial
damage. Moreover, this emergency room line of treatment increased the
frequencies of occurance oftachyeardia to 60% and cardiac ischemia to
55% . It was accompanied by myocardial infarction in one case (5%) and
atrial premature beats in another case (5%) . The frequency of occurance
of right ventricular hypertrophy increased slightly to become 50% that of
pulmonary hypertention remained the same (20%) while left ventricular
hypertrophy was not detected in this group.