528 - Effect of Body Mass Index on Electrocardiogram in Children Aged 2-7 Years with Still’s Murmur in a Multiethnic Community Hospital

Publication Number: 4516.528

Yasser M. Elhashash, Flushing Hospital Medical Center, brooklyn, NY, United States; Abdul Rahman, Flushing Hospital Medical Center, Flushing, NY, United States; Sana Amreen Shaikh, Flushing Hospital Medical Center, Flushing, NY, United States; Lily Q.. Lew, Flushing Hospital Medical Center, Flushing, NY, United States

Background: Childhood obesity has reached epidemic levels in the United States. The American Academy of Pediatrics 2023 Clinical Practice Guidelines recommends early screening for obesity, and for cardiovascular and metabolic comorbidities in those affected. Heart murmurs such as Still’s murmurs are commonly encountered during routine physical examinations in childhood and are most often benign.

Objective: To explore the association between body mass index (BMI) and electrocardiogram (EKG) abnormalities in children aged 2-7 years with Still’s murmur.

Design/Methods: A retrospective chart review of children aged 2-7 years with EKG obtained in the evaluation of benign heart murmurs between January 1, 2015 to December 31, 2024. Demographics (age, gender, ethnicity), BMI, and EKG report were extracted from electronic medical records. Charts were divided into normal, overweight and obese categories. A BMI between 5- < 85%ile for age and gender is normal, between 85- < 95%ile is overweight, and ≥95%ile is obese using CDC BMI charts. EKG was evaluated for heart rate, rhythm, axis, P wave, PR interval, QRS complex and QT interval, and grouped as normal or abnormal. The groups were compared. Data were analyzed using R software and multivariable logistic regression, p< 0.05 was considered statistically significant.

Results: Of a total of 101 patients, about a half (53%) were male with mean age of 3.5 years (SD=1.4). Majority were Hispanic (88%), followed by Asian (9%) in ethnicity reflective of our community. Most had a normal BMI (60%), a fifth (21%) were overweight, and the remainder (19%) were in the obese category. Abnormal EKG was in almost half (47%) of those who were obese compared to less than a third (28%) of those who were overweight, and about a quarter (23%) of those with normal BMI. Using multivariable logistic regression, adjusting for demographics, obese children had significantly higher odds of having an abnormal EKG compared to those with normal BMI (OR=3.47, CI=1.11-10.84, p=0.03). Overweight children were not associated with abnormal EKG findings (OR=1.52, p=0.48). Age, gender, and ethnicity were not significant predictors (all p>0.05).

Conclusion(s): In our small multiethnic sample, obese children have a significantly higher prevalence of EKG abnormalities compared to children with normal BMI. Health care providers should be aware of increased risk for EKG abnormalities in obese children, and to be mindful of the importance of cardiovascular screening and monitoring in this population.