Park's The Pediatric Cardiology Handbook

Obstructive Lesions

I. Pulmonary Stenosis A. Prevalence Isolated PS occurs in 4% to 8% of all CHDs. B. Pathology and Pathophysiology 1. PS may be valvular (90%), subvalvular (infundibular), or supravalvular (i.e., stenosis of the main PA). Stenosis of the PA branches…

Left-to-Right Shunt Lesions

I. Atrial Septal Defect (Ostium Secundum ASD) A. Prevalence Thirty to 40 percent of all CHDs. Female preponderance (male-to-female ratio of 1:2). B. Pathology and Pathophysiology 1. Three types of ASDs occur in the atrial septum ( Fig. 7.1 ).…

Congenital Heart Defects

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Invasive Procedures

There are two kinds of invasive procedures that are used in the practice of pediatric cardiology: diagnostic cardiac catheterization (including angiocardiography) and catheter intervention procedures (therapeutic cardiac catheterization). I. Cardiac Catheterization and Angiocardiography Cardiac catheterization and angiocardiography are the definitive…

Other Noninvasive Tools

Besides noninvasive imaging tools, there are other noninvasive investigational tools that are frequently used in the evaluation of cardiac patients. They include exercise stress testing, long-term ECG monitoring, and ambulatory blood pressure (BP) monitoring. I. Exercise Stress Testing Exercise stress…

Noninvasive Imaging Tools

I. Echocardiography Echocardiography (echo) is an extremely useful noninvasive test used in the diagnosis and management of heart disease. An echo study currently begins with real-time two-dimensional echo (2D echo), which produces high-resolution tomographic images of cardiac structures and their…

Chest Roentgenography

Chest radiography was an essential part of cardiac evaluation before the echocardiographic (echo) studies became widely available to cardiologists. This simple test remains very useful to physicians who do not have access to the echocardiograph. In addition, cardiovascular abnormalities may…

Electrocardiography

One normal cardiac cycle is represented by successive waveforms on an ECG tracing: the P wave, the QRS complex, and the T wave ( Fig. 2.1A ). These waves produce two important intervals, PR and QT, and two segments, PQ…

History and Physical Examination

I History Taking Prenatal, natal, perinatal, postnatal, past, and family histories should be obtained. A Gestational and Perinatal History 1. Maternal infection: Rubella during the first trimester of pregnancy commonly results in PDA and PA stenosis (rubella syndrome, see Table…