Title

Clinical Spectrum of Previoudly Undiagnosed Pediatric Cardiac Disease

Document Type

Article

Publication Date

2-22-2019

Publication Title

American Journal of Emergency Medicine

Volume

37

Issue

5

First page number:

933

Last page number:

936

Abstract

Previously undiagnosed pediatric cardiac disease represents a clinical challenge for the emergency physician. The clinical presentation of these disorders can mimic other conditions of the respiratory, gastrointestinal and neurologic systems at a time when the need for early identification and treatment is at a premium. A high index of suspicion and superb clinical acumen is required to make a timely diagnosis and initiate optimal care. Methods A retrospective chart review using explicit criteria and a structured data collection process was performed on all children presenting with previously undiagnosed cardiac disease over a five and half year period. Results Thirty-six patients were identified over a five and a half year period representing one patient per 4838 pediatric ED presentations. A diverse set of chief complaints, triage categories, clinical presentations and diagnoses were identified. Undiagnosed congenital lesions, acquired cardiac disease, dysrhythmias and infectious diseases of the heart were represented. The need for surgical intervention (22%) and mortality(6%) was substantial. Conclusion In the aggregate, these conditions occur at an important rate and represent a high risk subset of pediatric patients presenting to the emergency department. Individually, the conditions occur infrequently and ‘pattern recognition’ may not aid the clinician. Early diagnosis and prompt intervention is important in this population.

Keywords

Pediatrics; Cardiology; Triage; Congenital; Arrhythmia; Myocarditis

Disciplines

Cardiovascular Diseases | Pediatrics

Language

English

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