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Adolescent Cardiac Issues, an Issue of Pediatric Clinics

Penned By Richard Humes
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Adolescent Cardiac Issues, an Issue of Pediatric Clinics

Penned By Richard Humes
4.85 28,832 Ratings
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Editor's Note:
Most physicians entering the field of pediatric cardiology are drawn to it by an interest in the wide variety of congenital heart defects which present at various ages. Most congenital heart disease will be evident in early life, presenting with cyanosis, heart murmur, congestive heart failure or shock. Textbooks in pediatric cardiology are filled overwhelmingly with chapters on the various congenital heart lesions which are encountered, both rare and common. However, practicing pediatric cardiologists will be quick to point out that a significant number of referrals to any practice do not involve congenital heart problems. Reviewing our own statistics at the Children's Hospital of Michigan Cardiology Center for the past two years (2010-2012) reveals that outpatient visits for new patient consultations examined by age groups are: less than 1 year of age - 11%; 1-5 years - 23%; 6-10 years - 21%; 11-18 years - 45%. Retrospective data collected from billing codes, as in this brief survey, may imprecise. However, it does provide a snapshot of the usual referral problems encountered by pediatric cardiologists. In our practice, the most common overall reason for referral in all ages was "heart murmur", constituting 26% of total referrals. Second were rhythm and rhythm related problems (inclusive of palpitations, abnormal ECG and diagnosed premature beats) constituted 19% of the total. In the age group of interest for this book of 11-18 years, the most common presenting issues were rhythm related (23%) and chest pain (23%), followed by syncope or dizziness (19%) and heart murmur (12%). Congenital heart disease diagnoses encountered in the 11 to 18 year age group comprised only 6.5% of referrals within that age group. It is likely that many of these were not new diagnoses (with a few exceptions), but rather represented transfers to our practice. Our own outpatient clinical experience reveals that the majority of outpatients referred by pediatricians for pediatric cardiology evaluation are between the ages of 11 and 18. The majority of these new referrals are not for congenital heart disease. Our intent for this edition of Pediatric Clinics of North America is to describe the types of problems which seem to be of concern to the pediatric community within this age group and to describe strategies for evaluation.

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Length 265 Pages
Imprint Elsevier
Released April 11, 2014
Identifier (ISBN) 18847998
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Richard Humes
The Mind Behind the Work
Richard Humes

Richard Humes is the author of several novels. Originally from the East Coast, they now live in the Midwest with family. In addition to writing, Richard Humes enjoys gardening, cooking, and reading way past bedtime. Their work often explores the complexities of everyday life and human relationships.

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Sandra King
Sandra King March 27, 2024
"A very strong entry. The middle had a deliberate pace, but the climax was phenomenal. I would highly recommend this to discerning readers."
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"Exceeded all my expectations. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I am now a lifelong fan of this author."
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Nicholas Nguyen
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Mary Moore
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Ashley Clark
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George Garcia
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"Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem."
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"Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre."
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"Absolutely brilliant. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading."
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"Exceeded all my expectations. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I will undoubtedly revisit this masterpiece."
Edward Smith
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"A very strong entry. It held my rapt attention, even when certain twists were telegraphed. I would highly recommend this to discerning readers."
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"Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author."
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"I was completely blown away. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading."
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"Such a rich narrative. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. A true literary gem."
Edward Smith
Edward Smith February 21, 2025
"Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. I will undoubtedly revisit this masterpiece."
Nicholas Thompson
Nicholas Thompson January 30, 2025
"Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem."
Edward Scott
Edward Scott February 06, 2025
"Exceeded all my expectations. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading."
James Walker
James Walker January 20, 2025
"Exceeded all my expectations. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I will undoubtedly revisit this masterpiece."
Gary Williams
Gary Williams October 27, 2024
"A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me."
Michael Martinez
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Steven Moore
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Daniel Mitchell
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"Took a moment to build, but the payoff was spectacular. A brilliant concept executed with flair. Just a few pacing choices I would change. A very distinguished novel."
Kimberly Carter
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Carol Flores
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"I find myself somewhat conflicted. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. A fair 3 stars."
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