Chest Pain in Pediatric Patients Referred to Pediatric Cardiology Clinic

2013 ◽  
Vol 53 ◽  
pp. 988-990
Author(s):  
Majdi Jaafreh
Keyword(s):  
Chest Pain ◽  
Pediatric Patients ◽  
Pediatric Cardiology ◽  
Cardiology Clinic

scholarly journals Yield of Echocardiogram and Predictors of Positive Yield in Pediatric Patients: A Study in an Urban, Community-Based Outpatient Pediatric Cardiology Clinic

2018 ◽  
Vol 5 ◽  
pp. 2333794X1876914
Author(s):  
Ramya Deepthi Billa ◽  
Susan Szpunar ◽  
Lida Zeinali ◽  
Premchand Anne
Keyword(s):  
Pediatric Patients ◽  
Pediatric Cardiology ◽  
Age Group ◽  
Shortness Of Breath ◽  
Cumulative Yield ◽  
Community Based ◽  
Cardiology Clinic ◽  
First Time ◽  
Community Teaching ◽  
Echocardiographic Findings

The yield of outpatient echocardiograms varies based on the indication for the echocardiogram and the age of the patient. The purpose of this study was to determine the cumulative yield of outpatient echocardiograms by age group and reason for the test. A secondary aim was to determine the predictors of a positive echocardiogram in an outpatient cardiology clinic at a large community teaching hospital. We retrospectively reviewed the charts of 891 patients who had a first-time echocardiogram between 2011 and 2015. Positive yield was defined as echocardiographic findings that explained the reason for the echocardiogram. The overall positive yield was 8.2%. Children between birth and 3 months of age had the highest yield (34.2%), and children between 12 and 18 years of age had the lowest yield (1%). Patients with murmurs (18.1%) had the highest yield compared with patients with other signs or symptoms. By age group and reason, the highest yields were as follows: 0 to 3 months of age, murmur (39.2%); 4 to 11 months of age, >1 symptom (50%); and 1 to 5 years of age, shortness of breath (66.7%). Based on our study, the overall yield of echocardiograms in the outpatient pediatric setting is low. Age and symptoms should be considered before ordering an echocardiogram.

scholarly journals Development of quality metrics for ambulatory pediatric cardiology: Chest pain

2017 ◽  
Vol 12 (6) ◽  
pp. 751-755 ◽  
Author(s):  
Jimmy C. Lu ◽  
Manish Bansal ◽  
Sarina K. Behera ◽  
Jeffrey R. Boris ◽  
Brian Cardis ◽  
...  
Keyword(s):  
Chest Pain ◽  
Pediatric Cardiology ◽  
Quality Metrics

Appropriateness and Cost-Effectiveness of Echocardiograms Ordered by Pediatric Cardiologists and Primary Care Providers for Syncope

2021 ◽  
pp. 000992282110382
Author(s):  
Tracey M. Thompson ◽  
Ty E. Hasselman ◽  
Yanzhi Wang ◽  
David W. Jantzen
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Pediatric Cardiology ◽  
Cost Effective ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cost Effectiveness Ratio ◽  
Improve Cost Effectiveness ◽  
Cardiology Clinic ◽  
Improve Cost

The pediatric appropriate use criteria (AUC) were applied to transthoracic echocardiograms (TTE) ordered by primary care providers (PCPs) and pediatric cardiologists for the diagnosis of syncope to compare appropriateness ratings and cost-effectiveness. Included were patients ≤18 years of age from October 2016 to October 2018 with syncope who underwent initial outpatient pediatric TTE ordered by a PCP or were seen in Pediatric Cardiology clinic. Ordering rate of TTE by pediatric cardiologists, AUC classification, and TTE findings were obtained. PCPs ordered significantly more TTEs than pediatric cardiologists for “rarely appropriate” indications (61.5% vs 7.5%, P < .001). Cardiologists ordered TTEs at 17.2% of visits. Using appropriateness as a marker of effect, with the incremental cost-effectiveness ratio, it was more cost-effective ($543.33 per patient) to refer to a pediatric cardiologist than to order the TTE alone. This suggests that improved PCP education of the AUC and appropriate indications of TTEs for syncope may improve cost-effectiveness when using order appropriateness as a marker of effectiveness.

CHEST PAIN AND DEPRESSION

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 575-575
Author(s):  
R. J. Haggerty
Keyword(s):  
Major Depressive Disorder ◽  
Differential Diagnosis ◽  
Chest Pain ◽  
Depressive Disorder ◽  
Children And Adolescents ◽  
Pediatric Cardiology ◽  
Cardiovascular Disorders ◽  
Major Depressive ◽  
Cardiology Department ◽  
Depressed Group

The study reports on 100 children and adolescents evaluated in a pediatric cardiology department. The results state that 13% of the population met the criteria for Major Depressive Disorder based on DSM III. There were four patients who were referred because of chest pain. All of them were found to be free from cardiovascular disorders, but all were found to be in the depressed group. The authors emphasize the importance of chest pain in differential diagnosis of childhood depression.

Suggests More Tests for Chest Pain Diagnosis

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 143-144
Author(s):  
Michael F. Elmore ◽  
Glen A. Lehman
Keyword(s):  
Chest Pain ◽  
Physical Examination ◽  
Pediatric Patients ◽  
Laboratory Studies ◽  
Psychiatric Interview ◽  
X Ray ◽  
Pain Diagnosis ◽  
Chest X Ray ◽  
Pain Characteristics ◽  
Diagnostic Work

Driscoll et al. (Pediatrics 57:648, May 1976) reported a series of 43 patients with chest pain evaluated by history and physical examination, psychiatric interview, screening laboratory studies, ECG, and chest x-ray film. No organic cause was identified in 45% of patients, and various psychiatric aspects of the pain were discussed. The history obtained from pediatric patients is often suboptimal, and specific pain characteristics and associations cannot be defined. We therefore propose that more vigorous diagnostic work-ups are necessary before chest pain can be classed as "idiopathic."

Abstract P263: Symptomatic Post-Acute SARS-CoV-2-Infection Hypertension Syndrome

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Lauren East ◽  
Zainab Mahmoud ◽  
Amanda Verma
Keyword(s):  
Blood Pressure ◽  
Chest Pain ◽  
Vital Signs ◽  
Wilcoxon Test ◽  
Initial Visit ◽  
Office Visits ◽  
Paired Data ◽  
Cardiology Clinic ◽  
Blood Pressures

Introduction: The Post-COVID Cardiology Clinic at Washington University evaluates and treats patients with ongoing cardiovascular symptoms following acute COVID-19 infection. One clinical manifestation seen in the clinic is an increase in blood pressure, with associated symptoms like chest pain. Our investigation aims to describe the increase in blood pressure seen in symptomatic patients presenting to the Post-COVID Cardiology Clinic. Methods: The study employed a retrospective cohort design of consecutive adult patients who presented between September 2020 to May 2021 with cardiovascular symptoms following COVID-19 infection. Demographic information, symptoms, vital signs, and follow-up visit data were collected for the patients. To determine a baseline blood pressure, two blood pressure readings from office visits prior to COVID-19 infection were averaged. The blood pressure values were compared between baseline and cardiology office visits using a non-parametric Wilcoxon test for paired data. Results: One-hundred patients were included in the cohort (mean age 46.4 years (SD 46.4); 81% (81) female). At the initial visit, there was a significant increase in systolic (median 128 mmHg) and diastolic (median 83.5 mmHg) blood pressure from baseline (systolic median 121.5, p=0.029; diastolic median 76, p<0.001). All patients with an increase in blood pressure reported symptoms like chest pain. In the subset of 36 (36%) patients that have followed up, 35 (97%) patients were prescribed a new anti-hypertensive or required an increased dose of a prior anti-hypertensive at their initial visit. Blood pressures at follow-up were not significantly different from baseline (median systolic delta= 1.0mmHg, diastolic delta= -1.0mmHg; p>0.05), and 83% (30) reported improvement in symptoms. Conclusions: Patients presenting with cardiovascular symptoms post-acute COVID-19 show increased blood pressure when compared to blood pressure prior to infection. During subsequent follow-up appointments, patients showed improvement in their blood pressure and symptoms. While the pathophysiology has yet to be determined, it is likely related to the effects of a proinflammatory state, endothelial dysfunction, dysautonomia, or altered effects of the RAAS.

Design and implementation of a patient passport in a pediatric cardiology clinic

2020 ◽  
Vol 59 ◽  
pp. 101208
Author(s):  
Denis J. Donovan ◽  
Dylan Macciola ◽  
Erin A. Paul ◽  
Gabriel Rama ◽  
Usha Krishnan ◽  
...  
Keyword(s):  
Pediatric Cardiology ◽  
Design And Implementation ◽  
Cardiology Clinic

Chest Pain in Pediatric Patients Presenting to an Emergency Department or to a Cardiac Clinic

2004 ◽  
Vol 43 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Martial M. Massin ◽  
Astrid Bourguignont ◽  
Christine Coremans ◽  
Laetitia Comté ◽  
Philippe Lepage ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Pediatric Patients

scholarly journals Behcet`s syndrome with coronary arteritis

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Khurram Ahmad ◽  
Waqas Chishti ◽  
Jawwad Yusuf ◽  
Madiha Jawwad
Keyword(s):  
Chest Pain ◽  
Illicit Drugs ◽  
Gastrointestinal Symptoms ◽  
African American Female ◽  
Her Family ◽  
Labia Minora ◽  
Coronary Arteritis ◽  
Ankle Joints ◽  
Cardiology Clinic ◽  
Artery Disease

Forty nine years old African American Female with Past medical h/o HTN, Behcet`s Syndrome since 1988 with recent flare up of disease with oral and genital ulcers, headache, arthralgia and gastrointestinal symptoms was referred to cardiology clinic with do chest pain for 4 days, reterosternal, non radiating,4/10 in intensity, no aggravation on exertion, relieved by SL nitroglycerine associated with mild SOB, nausea and diaphorersis. Patient denied tobacco, alcohol and illicit drugs. Never had similar chest pain before. Review of system was unremarkable except for Behcet`s Syndrome flare up. Her medications were tenolol, Valsartan, Indocin, ASA, Lortab, Zoloft, Premarin, Triamatrene and Tagamet. Her family history was negative for coronary Artery disease. On physical exam pt was afbrile, heart rate 52/min,blood pressure 140/90, respiratory rate 16/min average built female 3-4 oral mucosal ulcers. Eye exam was unremarkable. Cardiac exam showed normal Sl and S2,no added sounds. Abdomen was soft, non tender and no hepatosplenomegaly. Her Right knee and both ankle joints were mildly tender without signs of effusion. Her genital exam revealed 2-3 small painful ulcers on labia minora. Rest of systemic exam was unremarkable.

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