International Journal of Medical Science in Clinical Research and Review Online ISSN: 2581-8945 Available Online at http://www.ijmscrr.in Volume 6|Issue 01 (January-February)|2023 Page: 109-118 IJMSCRR: January-February 2023 http://doi.org/10.5281/zenodo.7565441 Page | 109 Original Research Paper Incidence of Cardiopulmonary Manifestations in Patients with Adenotonsillar Hypertrophy Authors: Lim Jun yi, Mustafa Abrar Zaman , Sehrish khan , Soumya Bhattacharya , Sameer Ul Haq , Zainab Aziz Chaudhry , Faryal Rafique , Neda Mumcu. Anum Naseer, Misha Anam 1 I.K. Akhunbaev Kyrgyz State Medical Academy 2 Medical School- St. George's University 3 Karachi Medical and Dental College 4 Dr B C Roy Pgips 5 Dow University Hospital 6 Ameer ud Din Medical College 7 Nishtar Hospital Multan 8 Yeditepe University 9 Karachi Medical and Dental College 10 Children Hospital & The Institute of Child Health, Lahore Corresponding Author: Misha Anam Children Hospital & The Institute of Child Health, Lahore Article Received: 15-12-2022 Revised: 05-01-2022 Accepted: 24-01-2023 ABSTRACT: Background: Adenotonsillar hypertrophy (ATH) is a common clinical problem in the pediatric age group. The treatment is primarily through oral medications and precautionary measures. In case of persistent and refracting cases causing significant airway obstruction, adenotonsillectomy is advised. In severe ATH and longstanding obstruction of airway, patient is prone to develop apneic spells and cardiopulmonary compromise. It then becomes essential to perform cardiac evaluation in such cases for effective management of the disease. Objective: To evaluate the incidence of cardiopulmonary complications in children with longstanding adenotonsillar hypertrophy and significant airway obstruction. Study Design: This is a tertiary hospital based observational prospective study at the Otorhinolaryngology, Department of Children Hospital and Institute of Child Health, Lahore, from October 2021- November 2022. Results: Total 110 patients were enrolled in this study with male to female ratio of 1.6:1. According to Brodsky classification, 82 (75%) had grade 3+ whereas 28 (25%) had grade 4+ tonsillar hypertrophy. All the patients had symptoms of moderate or severe snoring and apnea. ECG and Echocardiography of all the 110 patients showed cardiac manifestations which was completely resolved in 107 patients after 6 months of adenotonsillectomy, 2 patients were having remitting features and only one patient had persistent cardiac anomaly which was referred to cardiology dept. for further investigation. Conclusion: Cardiac complications are found common in children suffering from severe adenotonsillar hypertrophy with OSAS for a prolonged period. In patients with significant (>60%) airway obstruction, pre-op cardiac evaluation and post operative cardiac monitoring is essential. Keywords: Obstructive sleep apnea syndrome (OSAS), adenotonsillar hypertrophy, electrocardiography, ECG changes, adenotonsillectomy. INTRODUCTION: Sore throat is the most common cause of ambulatory outpatient visits in childhood, worldwide [1]. Acute tonsilitis among pre-teens (5yrs-14yrs) accounts for approximately 2% and 1.3% of total pediatric outpatient visits in United States and worldwide, respectively [2] whereas, 34% (Confidence interval 95%, 1.3%-50.6%) of sore throats are diagnosed as adenoiditis, annually [3]. The prevalence is recorded higher in Asia than in Africa and America (48.0%, 95% CI[-2.0%, 98.0%], 27.0%, 95% CI[17.0%, 38.0%] and 24.0%, 95% CI[1.0%, 46.0%]), respectively. [4,5] The prevalence of adenotonsilitis remarkably decreases with age [4]. Viral etiology is common in children under 5 however, in the