Pediatric cardiology
-
Pediatric cardiology · Mar 2004
Case ReportsNeonatal intractable atrial flutter successfully treated with intravenous flecainide.
We present a neonatal case with intractable atrial flutter that did not respond to digitalization and electrical cardioversion. Intravenous flecainide administration completely resolved the atrial flutter. Proarrhythmic effects were not induced by flecainide administration. Although the efficacy of flecainide for atrial flutter during the infantile or childhood period is low, intravenous flecainide is worth consideration as a treatment for atrial flutter, even in intractable cases as described here, during the neonatal period.
-
Pediatric cardiology · Mar 2004
Case ReportsSuccessful treatment of long QT syndrome-induced ventricular tachycardia with esmolol.
Esmolol is a cardioselective beta-blocker with very rapid onset of action and short half-life due to its metabolism by blood-borne esterases. This unique profile among currently available beta-blockers renders esmolol highly useful in critical care situations. However, published experience with the use of esmolol in critically ill children is scant. The case of a 4-year-old boy with secondary long QT syndrome and ventricular tachycardia successfully treated with esmolol is presented.
-
Pediatric cardiology · Jan 2004
Clinical TrialIntravenous nicardipine for treatment of postcoarctectomy hypertension in children.
Our objective was to evaluate the efficacy of intravenous (IV) nicardipine for the treatment of postcoarctectomy hypertension in children with coarctation of the aorta. We carried out a retrospective review in a pediatric intensive care unit at a tertiary care children's hospital. The patients were children with coarctation of the aorta treated for postcoarctectomy hypertension. ⋯ We concluded that IV nicardipine reduced MAP with no significant change in mean HR and no adverse effects in patients with postcoarctectomy hypertension. Nicardipine produced a further reduction in MAP in children receiving other antihypertensive agents. Nicardipine is an effective agent for treatment of postcoarctectomy hypertension in children with coarctation of the aorta.
-
Pediatric cardiology · Jan 2004
Case ReportsImpaired left ventricular function after arterial switch operation: exclusion of significant coronary artery stenosis with an intravascular Doppler guidewire.
Patients after arterial switch operation for transposition of the great arteries are at risk for coronary artery stenosis or obstruction due to intraoperative manipulation. This case describes an infant with impaired left ventricular function 8 months after arterial switch operation. A hemodynamically significant left coronary artery stenosis was excluded by determination of coronary flow reserve using an intravascular Doppler guidewire.
-
Pediatric cardiology · Jul 2003
Comparative StudyThe emergency department versus the computer: which is the better electrocardiographer?
Electrocardiograms (ECGs) are frequently ordered in the pediatric emergency department (ED). Pediatric cardiologists are generally not asked to interpret every ECG; thus, ED patient management is often guided by the ED physicians' ECG interpretation. The objective of this study was to analyze the accuracy of ECG interpretation by ED physicians and a computer-generated interpretation and compare the two. ⋯ For the class IV ECGs, both the computer and the ED physicians performed poorly, correctly interpreting just 14% and 28%, respectively. The computer proved to be more accurate than the ED physicians in interpreting ECGs of less than critical significance (classes II and III), but neither group was able to correctly interpret even a simple majority of the most significant abnormalities (class IV). We speculate that distributing the computer-generated interpretation to the ED physicians and formal review of all ED ECGs by a skilled interpreter may decrease the number of missed diagnoses.