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https://www.readbyqxmd.com/read/28319472/infective-endocarditis-in-children-an-update
#1
Garth Dixon, Georgi Christov
PURPOSE OF REVIEW: Infective endocarditis in children remains a clinical challenge. Here, we review the impact of the updated 2015 American Heart Association and European Society of Cardiology guidelines on management as well as the significance of the new predisposing factors, diagnostic and treatment options, and the impact of the 2007-2008 change in prophylaxis recommendations. RECENT FINDINGS: The new 2015 infective endocarditis guidelines introduced the endocarditis team, added the new imaging modalities of computer tomography and PET-computer tomography into the diagnostic criteria and endorsed the concept of safety of relatively early surgical treatment...
March 17, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28299882/systolic-ejection-click-versus-split-first-heart-sound-are-our-ears-deceiving-us
#2
Natalie M Hoeting, Courtney E McCracken, Michael McConnell, Denver Sallee, Glen J Iannucci, Matthew E Oster
OBJECTIVE: Bicuspid aortic valve (BAV) disease is associated with potential lifetime complications, but auscultation of a BAV click is commonly missed or mistaken for a benign split first heart sound. Our objective was to determine whether pediatric cardiologists could reliably distinguish between BAV clicks and benign split first heart sounds. DESIGN: Quality evaluation project using de-identified recordings from an outpatient pediatric cardiology clinic. OUTCOME MEASURES: Twenty-one cardiologists listened to five de-identified recordings of pediatric heart sounds (three with BAV clicks, two with mitral components of benign split first heart sounds) and indicated whether they believed each recording was a BAV or split first heart sound...
March 16, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28295809/a-new-method-to-predict-the-need-for-a-rashkind-procedure-in-fetuses-with-dextro-transposition-of-the-great-arteries
#3
Maciej Słodki, Roland Axt-Fliedner, Katarzyna Zych-Krekora, Aline Wolter, Andreea Kawecki, Christian Enzensberge, Ewa Gulczyńska, Maria Respondek-Liberska
OBJECTIVE: Prenatal congenital heart disease classification system specify critical d-TGA with restriction of the foramen ovale (which requires Rashkind procedure) and planned d-TGA. However, current prenatal diagnostic criteria for post-delivery foramen ovale (FO) restriction in d-TGA are inadequate, resulting in a high false negative rate. We aim to find an echocardiographic features to predict the need for Rashkind procedure. METHODS: 98 patients from 2 European centers diagnosed prenatally with fetal d-TGA from 2006 to 2013 were analyzed and two groups were compared: 1) those in which the Rashkind procedure was performed within the first 24 hours of life; and 2) those who did not undergo a Rashkind procedure before cardiac surgery...
March 14, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28285866/obstructed-infradiaphragmatic-total-anomalous-pulmonary-venous-return-in-a-13-day-old-infant-presenting-acutely-to-the-emergency-department-a-case-report
#4
Elizabeth A Siacunco, Garrett S Pacheco, Dale P Woolridge
BACKGROUND: Total anomalous pulmonary venous return (TAPVR) is an uncommon congenital heart defect. Obstructed forms are more severe, and typically present earlier in life, usually in the immediate newborn period, with symptoms of severe cyanosis and respiratory failure. CASE REPORT: A 13-day-old boy presented to the emergency department (ED) with respiratory extremis. He appeared cyanotic and limp, and was found to have significant hypoxia with oxygen saturation of 40%...
March 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28284205/usage-of-3d-models-of-tetralogy-of-fallot-for-medical-education-impact-on-learning-congenital-heart-disease
#5
RANDOMIZED CONTROLLED TRIAL
Yue-Hin Loke, Ashraf S Harahsheh, Axel Krieger, Laura J Olivieri
BACKGROUND: Congenital heart disease (CHD) is the most common human birth defect, and clinicians need to understand the anatomy to effectively care for patients with CHD. However, standard two-dimensional (2D) display methods do not adequately carry the critical spatial information to reflect CHD anatomy. Three-dimensional (3D) models may be useful in improving the understanding of CHD, without requiring a mastery of cardiac imaging. The study aimed to evaluate the impact of 3D models on how pediatric residents understand and learn about tetralogy of Fallot following a teaching session...
March 11, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28279544/inferior-vena-cava-filter-limb-fracture-with-embolization-to-the-right-ventricle
#6
Bradley S Jackson, Mykel Sepula, Jared T Marx, Chad M Cannon
BACKGROUND: Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. CASE REPORT: A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain...
March 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28277918/concordance-of-fetal-echocardiography-in-the-diagnosis-of-congenital-cardiac-disease-utilizing-updated-guidelines
#7
Marijo Aguilera, Kirsten Dummer
OBJECTIVE: We sought to examine the concordance of prenatally diagnosed congenital cardiac disease with postnatal echocardiography. STUDY DESIGN: Patients who underwent fetal echocardiograms performed by pediatric cardiologists at a single referral center from January to December 2014 were reviewed. Fetal echocardiography exams were performed in accordance with guidelines by the American Institute of Ultrasound in Medicine (AIUM) and the American Heart Association (AHA) guidelines (2013 and 2014, respectively)...
March 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28268118/the-role-of-early-focused-cardiac-ultrasound-in-a-not-so-typical-presentation-of-takotsubo-cardiomyopathy-a-case-report
#8
Jithin G Varghese, Qurat-Ul-Ain Jelani, Stuart Zarich, Brooks Walsh
BACKGROUND: Focused cardiac ultrasound (FoCUS) can be extremely helpful in identifying unexpected diagnoses that can significantly alter treatment options. The diagnosis of Takotsubo cardiomyopathy (TCM) may be difficult to identify. CASE REPORT: We describe a 47-year-old woman who presented to the emergency department (ED) with atypical features of TCM. Her clinical features included being a premenopausal woman with mild chest pain with a lack of identifiable emotional or physical stressors or significant electrocardiographic changes...
March 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28265962/treatment-of-fetal-supraventricular-tachycardia
#9
REVIEW
Bridget B Zoeller
Fetal arrhythmia is a common reason for referral to fetal cardiology. Fetal supraventricular tachycardia can be subdivided into several groups with the most common being re-entrant supraventricular tachycardia and atrial flutter. Fetal tachycardia can lead to hydrops fetalis, which increases the risk of fetal demise, perinatal morbidities, and premature delivery. The diagnosis of fetal tachycardia can be a challenge as a traditional electrocardiogram cannot be completed on a fetus, and other methods must be used by fetal echocardiogram...
January 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28258942/late-onset-of-neutral-lipid-storage-disease-due-to-novel-pnpla2-mutations-causing-total-loss-of-lipase-activity-in-a-patient-with-myopathy-and-slight-cardiac-involvement
#10
Sara Missaglia, Lorenzo Maggi, Marina Mora, Sara Gibertini, Flavia Blasevich, Piergiuseppe Agostoni, Laura Moro, Denise Cassandrini, Filippo Maria Santorelli, Simonetta Gerevini, Daniela Tavian
Neutral lipid storage disease with myopathy (NLSDM) presents with skeletal muscle myopathy and severe dilated cardiomyopathy in nearly 40% of cases. NLSDM is caused by mutations in the PNPLA2 gene, which encodes the adipose triglyceride lipase (ATGL). Here we report clinical and genetic findings of a patient carrying two novel PNPLA2 mutations (c.696+4A>G and c.553_565delGTCCCCCTTCTCG). She presented at age 39 with right upper limb abduction weakness slowly progressing over the years with asymmetric involvement of proximal upper and lower limb muscles...
January 17, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28225219/educational-intervention-for-improving-the-appropriateness-of-transthoracic-echocardiograms-ordered-by-pediatric-cardiologists
#11
Ritu Sachdeva, Pamela S Douglas, Michael S Kelleman, Courtney E McCracken, Leo Lopez, Kenan W D Stern, Benjamin W Eidem, Oscar J Benavidez, Rory B Weiner, Elizabeth Welch, Robert M Campbell, Wyman W Lai
OBJECTIVE: The objective of this study was to evaluate effectiveness of educational intervention (EI) in the Pediatric Appropriate Use of Echocardiography (PAUSE) study to improve appropriateness of transthoracic echocardiograms (TTEs) ordered in pediatric cardiology clinics. DESIGN: Data were prospectively collected after the publication of the Appropriate Use Criteria (AUC) document during 2 phases: the pre-EI phase (1/1/15 to 4/30/15) and the post-EI phase (7/1/15 to 10/30/15)...
February 22, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28215417/prenatal-diagnosis-of-the-criss-cross-heart
#12
Prasad Ravi, Deborah Fruitman, Lindsay Mills, Timothy Colen, Lisa K Hornberger
We sought to describe the prenatal features and postnatal outcomes of the "criss-cross heart" (CCH) with crossing atrioventricular connections as encountered in 5 cases and to review the literature regarding fetal diagnoses of this lesion. We reviewed the clinical history and fetal echocardiograms of 5 patients with a diagnosis of CCH encountered in our institution from 2010 to 2015. Affected pregnancies were identified through the University of Alberta fetal cardiology database. Fetal and postnatal echocardiograms, prenatal and postnatal clinical records, autopsy, and surgical reports were reviewed...
March 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28197939/prenatal-counseling-of-fetal-congenital-heart-disease
#13
REVIEW
Caroline K Lee
The field of fetal cardiology has advanced greatly over the last two decades and congenital heart defects can now be identified in utero with a high level of accuracy. Prenatal counseling of parents given the news of a fetal cardiac defect is an important role of the fetal cardiologist. Prenatal counseling is a complex task that requires skill to perform and interpret fetal echocardiograms, an understanding of fetal and postnatal cardiovascular physiology, knowledge of therapeutic and surgical options, and of long-term outcomes including quality of life...
January 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28177138/application-of-pediatric-appropriate-use-criteria-for-initial-outpatient-evaluation-of-syncope
#14
Heather M Phelps, Michael S Kelleman, Courtney E McCracken, Oscar J Benavidez, Robert M Campbell, Pamela S Douglas, Benjamin W Eidem, Wyman W Lai, Leo Lopez, Kenan W D Stern, Elizabeth Welch, Ritu Sachdeva
BACKGROUND: Syncope is a common reason for outpatient transthoracic echocardiography (TTE). We studied the applicability of pediatric appropriate use criteria (AUC) on initial outpatient evaluation of children (≤18 years) with syncope. METHODS: Data were obtained before (Phase I, April-September 2014) and after (Phase II, January-April 2015) the release of the AUC document from six participating pediatric cardiology centers. Site investigators determined the indication for TTE and assigned appropriateness rating based on the AUC document: Appropriate (A), May Be Appropriate (M), Rarely Appropriate (R), or "unclassifiable" (U) if it did not fit any scenario in the AUC document...
March 2017: Echocardiography
https://www.readbyqxmd.com/read/28151505/-a-late-diagnosis-of-left-atrial-myxoma-how-to-gain-time
#15
Ferdinando Maria Massari, Tatiana Tonella, Giuseppe Pomè, Alessandra Di Mauro, Claudio Clemente, Federico Lombardi
A 56-year-old man presented to the Outpatient Cardiology Unit for dyspnea that had been lasting 6 months and an occasional episode of cold perspiration on climbing a flight of stairs. In the suspicion of coronary artery disease, he was prescribed a complete blood panel, an echocardiogram and a treadmill stress test. The echocardiogram, performed as late as 78 days after the first evaluation and only by chance scheduled 2 days before the stress test, enabled a diagnosis of left atrial myxoma for which the patient successfully underwent cardiac surgery...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28150025/initial-field-test-of-a-cloud-based-cardiac-auscultation-system-to-determine-murmur-etiology-in-rural-china
#16
Lee Pyles, Pouya Hemmati, J Pan, Xiaoju Yu, Ke Liu, Jing Wang, Andreas Tsakistos, Bistra Zheleva, Weiguang Shao, Quan Ni
A system for collection, distribution, and long distant, asynchronous interpretation of cardiac auscultation has been developed and field-tested in rural China. We initiated a proof-of-concept test as a critical component of design of a system to allow rural physicians with little experience in evaluation of congenital heart disease (CHD) to obtain assistance in diagnosis and management of children with significant heart disease. The project tested the hypothesis that acceptable screening of heart murmurs could be accomplished using a digital stethoscope and internet cloud transmittal to deliver phonocardiograms to an experienced observer...
February 2, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28139440/the-parasternal-short-axis-view-improves-diagnostic-accuracy-for-inferior-sinus-venosus-type-of-atrial-septal-defects-by-transthoracic-echocardiography
#17
Brian S Snarr, Michael Y Liu, Jeremy C Zuckerberg, Christine B Falkensammer, Sumekala Nadaraj, Danielle Burstein, Deborah Ho, Monique A Gardner, Arene Butto, Stanford G Ewing, Natesa G Pandian, Anirban Banerjee
BACKGROUND: Sinus venosus defects (SVD) of the inferior vena cava (IVC) type, or inferior SVDs, are an uncommon form of atrial communication located outside the confines of the fossa ovalis and involve override of the IVC. Despite numerous studies describing the anatomical and echocardiographic features of the inferior SVD, distinguishing this defect from a large secundum atrial septal defect (ASD) by echocardiography is often challenging. Accurate diagnosis of an inferior SVD and correct differentiation from a secundum ASD is essential for appropriate presurgical planning...
March 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28130566/-stress-echocardiography-and-its-central-role-in-cardiac-diagnostics
#18
R Leischik, B Dworrak, T Cremer, S Amirie, H Littwitz
Stress echocardiography (SE) has an established central role as a diagnostic tool in cardiology. It is not only an established method for the diagnostic and prognostic stratification of patients with coronary artery disease but also shows an emerging value for assessment of cardiac function beyond coronary artery disease. The enormous conceptual technological development of ultrasound technology (Doppler, digitizing, tissue Doppler imaging, strain technology, 3‑D-echo and new ultrasound contrast agents) has led to applications of SE in almost all diagnostic fields of cardiology...
January 27, 2017: Herz
https://www.readbyqxmd.com/read/28110851/is-an-abnormal-ecg-just-the-tip-of-the-ice-berg-examining-the-utility-of-electrocardiography-in-detecting-methamphetamine-induced-cardiac-pathology
#19
Elizabeth D Paratz, Jessie Zhao, Amanda K Sherwen, Rose-Marie Scarlato, Andrew I MacIsaac
BACKGROUND: Methamphetamine use is escalating in Australia and New Zealand, with increasing emergency department attendance and mortality. Cardiac complications play a large role in methamphetamine-related mortality, and it would be informative to assess the frequency of abnormal electrocardiograms (ECGs) amongst methamphetamine users. OBJECTIVE: To determine the frequency and severity of ECG abnormalities amongst methamphetamine users compared to a control group...
December 9, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28101033/maximizing-the-benefit-cost-ratio-of-anthracyclines-in-metastatic-breast-cancer-case-report-of-a-patient-with-a-complete-response-to-high-dose-doxorubicin
#20
Kevin Shee, Alan T Kono, Susan P D'Anna, Mark A Seltzer, Xiaoying Lu, Todd W Miller, Mary D Chamberlin
Despite the clinical efficacy of anthracycline agents such as doxorubicin, dose-limiting cardiac toxicities significantly limit their long-term use. Here, we present the case of a 33-year-old female patient with extensive metastatic ER+/PR+/HER2- mucinous adenocarcinoma of the breast, who was started on doxorubicin/cyclophosphamide therapy after progressing on paclitaxel and ovarian suppressor goserelin with aromatase inhibitor exemestane. The patient was comanaged by cardiology, who carefully monitored measures of cardiac function, including EKGs, serial echocardiograms, and profiling of lipids, troponin, and pro-BNP every 2 months...
September 2016: Case Reports in Oncology
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