Table Of Content

D ow nloaded from https://onlinelibrary.w Moller’s Essentials of iley.com Pediatric Cardiology /doi/ by ibrahim ragab - Cochrane G erm any , W iley O nline Library on [23/11/2022]. See the Term s and Conditions (https://onlinelibrary.w iley.com /term s-and-conditions) on W iley O nline Library for rules of use; O A articles are governed by the applicable Creative Com m ons License D ow nloaded from https://onlinelibrary.w iley.com Moller’s Essentials /doi/ by ibrahim oCaf rPdeidoilaotgryic ragab - Cochrane Germ any , W iley O FWPrOoafelUstseoRrr oTHf HP. eJd oiEahtDrnicssIToInO, JNr., MD nline Library on [23/11/2022]. See the Term DDUBieinrvmpiivsaeiionrrtnsgmi htoyea fnmo Ptf ,e o AdAfl iLaaP,bte rUadicmSi aACatra iacrdts iBoilromgiyngham s and Conditions (https://onlinelibrary.w Camden L. Hebson, MD iley.com Associate Professor of Pediatrics /term DDUeinvpiivsaeiorrtnsmi toye fno Ptf e oAdfl iaaPbteradicmi aCatra iacrdts iBoilromgiyngham s-and-conditions) on W Birmingham, AL, USA iley O nline Library for rules of use; O A articles are governed by the applicable Creative Com m ons License D ow nloaded from https://onlinelibrary.w T©EJohd hii2stni0 oe 2Wnd3 itHi liJeoiosynht o &nfri rySWsot inlpesuy, b L&lti sdSh o(e3ndes , 2 L20t0d2134). iley.com/doi/ by ibrahim Aiphnetl ltar prmni:g/yi/ht wtfteoswd rrm webs .yeow rlrvai lbeewdyy.. . ca ANondmoyv /impcgaeoer a/top nonesf r,h m teohliwiesssc pittorouno bosnl.ibiccta,a tmiinoe npc mehraamnyii csbsaeilo, r npe phtoroo trdoeucuocsepedy m,i nsagtot,e rrreeidac lo infrrd oaimn rge tt ohrireis vo tatilth lseey rsiwst eiasmvea,, ioelarxb ctlreeap nats tam s itted, ragab - Cochrane G erm Tbheee nr igashste ortfe Wd ianlt aecr cHo.r dJoahnnceso wn,it Jhr .l aawnd. Camden L. Hebson to be identified as the authors of this work has any , W Registered Offices iley O aTJJFvWIpaLTodmoinnooroiihpsnifesmaa co hhsirteiprlml.dgtoy hdmenni det aenccuyeie a afeioniWWmo o ssidanratpcn sdfssatidaaal iaciiie ts/ollListit roieeelcodnna,is iknaok nyywr roes. po bwsaent i:&&srwttsA ugf is ,asW lin t ,itbeoowl SSetnr hloac y elfuooqidii.o ft lh/snaweatfr nnuDathiahi tsynhnlssigrmiieeinpi lds, aytesealrs Lcgmeo t eIrty ntpwnplen eib.nadttoedcrcsrsdsiraot,oino mr. a neil,t irbTbdn tmn idhktdene,1hyou eed tvr.sga 1aeocah mp teinoro 1tWtnrkeheAr oudvfa sosd yR etric UiriWr lonsdriikitersn aivininvnteuchsyol eaeei ivmas motanaorrnln ie o rucnorsfveSd,addefeg lsafntenfdiS o s corrotSttfdo t,eierhhao n reyt eauts aemltirothe ,strot yt r e,t aaehpeece b onfcH beusgrntrouho fyrreesouta oran ptia etblpnomordka hedleGoadnem etreeelmirkc eitmoardetroyeted i tnadricg tiraenc osohys u ieri, s,nu, nnfe kul n en CaN paierstrrtecor h gnoh,vhJ c or t pfeiednaieoi 0ccrosbiadlq eur h7 trartbe s ushmene0irtsc e,oeoige tas 3ipanrearost ive0mirscepttnnekaecst.o,retds. ei , eovlIina U cnafri nWmaemitnesbS ctnitwvdvd,m Aleaod iree eo sentrb ae twremirsotn ynna e Sdwf i dddaaopnluoeoy iernfrfsntevcw imohsenniovghcerre aotn ,aemsoxo -rlt.rgu u, o f r fk af Jobna PonoisotpntiedOr- irnh,eorof d me o1ogu annfertm r9 samsh mJrmWaett oeeoa8osbdasha t.niSnioe nlitnnwendQaigudof ygirW oit,n.n tco &rhUgSsWh tmircooh l,,KeeS i iueemaaellyoaenrtntq n iet y&todtuwi sinhf pnc i,Spdirgi oc rniIopmiot n nsgttmnrdccoeteossue.un e,n v,t nsic t histsdhtt ei snoeot hodundat s , et nline Library on [23/11/2022]. See the Terms and Conditions (https://onlinelibrary.w apnuyb lcishhaenrg aensd in a uththe oinrss thruavceti ounsse do rt hinediri cbaetsiot ne fofof rutss aing ep arenpda froinrg a tdhdise dw worakr,n tihnegys manadk ep rneoc arueptiroensse.n Wtahtiiolen sth e iley.com or warranties with respect to the accuracy or completeness of the contents of this work and specifically /term dpoianniars trdcphtl iraaciosiuum mwltah ooarot lrpilrko suw n areaapsnlr o adrsas otcenari.ttts eaiNeemt soito,h e wnienn atcaisnrlnu rffdaodon/rironmt trygh ap miwtsoi oaitwteynh on boorteukira .tscl eTlrsierhmovaeuiitc trefaecadtseci oottoh nrtf eh eaf auxonttrry etga hnianmedn roepi zirdlnagie ftbadoiony r wnimsz,aaa alwtretirioseao nbnrne,st piidwetreosee, e sobosefs rn ni mtptoear,ett o roimvcdrehu epsaca,rnt now tm datrhubiataciytletit t pnyitsrh oosreaver lipfefdeiuster nbr moeelidrssa sh tt eeforor i ar las s-and-conditions) on W rine croemndmereinndga ptiroonfes sisti omnaayl smearvkiece. sT.h Tish ew aodrkv iicse s aonldd wstirtaht ethgeie us ncdoenrtsatianneddi nhge rtehinat m thaey pnuobt lbiseh esur iitsa nbolet feonrg yaoguerd iley O dLswwISiiatbBehumrbNeaasna:tri ig yt9oie te7no ssi8. sf, l iY1Csrineot1oecau1ndldu 9gs .di8h rnNie2on ets9ughsi7lt idhCbs3 euacw7rtto ao(tnnplhrosokaeugt p m lpitleni umrawgbby-iia tl itihnehcsad-hk Pav )etu eros b pnc lsehiopccaraei natacigliuoiasetnlth,d wDoi norhacrst ei ddasrh eeisaan aapltplppa pbpll,ieee rcoa dlorip aenfrbodisal reetbqe efu.ot eFwrun aertnetiahnyle , l wroo, srhrs eeo aontdhf teephrrris osd sfwahitmo oourarklg d aew nbsay.e s o awtwhreiatrrt eec not hmaanmtd e rcial nline Library for rules of use; O A CCSeootvv ieenrr 8DIm/e1as0gigpent: :FC WruotuiliegrtyeersLyT Sotfd R boyb bSt Rraoivmep, Pondicherry, India articles are governed by the applicable Creative Com m ons License D ow nloaded from https://onlinelibrary.w Contents iley.com /doi/ by ibrahim ragab - Cochrane G Preface, vii erm 1. Tools to diagnose cardiac conditions in children, 1 any , W 23456..... EiCACCnnlnoo avconnsihrsmdgoiiliefdtnainicrlomieaietnntaesis,o ln woh7ntabie0 talash natr rtndau d dclpe itsghfinetey-agsntsio eoeb-tl lroiwociggo ichtydoh t o n fsafldho criuwtiogino nhitnng tis -nec tna ohcsi-ihtlsladeoillrfd cethir naeset,hna e1ur,d t4n9 dw6t3 iisinteh ac shheiel dainrre tc ndh,ii sl1de8rae2sne, 83 iley Online Library on [23/11/2022]. See the Term 1 178901..... UUTAChnnboeuinnq sogcuuareemars dltc aiifavaloierctdr i mehciasoesc ano orcdftfo i h tfnciaeoodianlniurtsgtir o eearn ancisntqi et uiain nailr fnnheaddeenw a tcdrsobtu anordindrnisnduge ci acncthsihfoeiailn ldnidn rtihen sco,n hco2, hidl43di,l21dr 2e1rn5en,6 ,2 23808 s and Conditions (https://onlinelibrary.w 12. A healthy lifestyle and preventing heart disease in children, 325 iley.com /term AIndddeixt,io 3n7a1l reading, 370 s-and-conditions) on W iley O nline Library for rules of use; O A v articles are governed by the applicable Creative Com m ons License D ow nloaded from https://onlinelibrary.w Preface iley.com /doi/ by ibrahim ragab - Cochrane G Since the first printing of this text 50 years ago, pediatric cardiac catheterization, erm echocardiography, computed tomography, and magnetic resonance imaging have any , W detprahwehvneaoileaTtivtduehsilehe usse clien aoa sh urt tpoeec ibpnwefsafofoitgdrnii odcnt Xehaeaki a-dnre rc ac faidct doa yafh firl,riinaen ednmog srdidaasr uni ip tcnnrleohap eggmpsetfr.t eeoa pitTsccrthah ri hoceaagtarmhentlous c tticbtuis.hodho ign nhMeeuahliaa liq d odnctspuii sa eoabrstersogn ueds ppn g ebiraooeongyacrrfs ec ptwadttspilhictsiathha s eicapoyieg ce srntsnchodirsecaoa mb aroraisslndletne ,iii pmencn aht rxtcghco a a p aeeciwmtsrnn toesmiedtitu snevia oeoeaierpnn.r,ntr ep,ttiae o eeltd ryngd,rpo a,r rtmb adahneyticeetilo toeiadmoitctnni nic.tho raioaTaonnllfo v cfe msa etartehn ruetvadethtdac ihooehelcuorregni seadscrttftsa,hsooe miroto rlyodearf,, iley Online Library on [23/11/2022]. See the Term brpdofpeoheriraca rET ym tgdcvthslytinieiameaic tonne gaibios sanln ttotneggihoicomexe os okarsmeua mtfdwhtug eer aidhincendlsloi fta e. ea.ar1t srr pTi2 eropphpa cnacelirtsst,helr i. yfeecba olinipoeanrttmoct eemtmkrre osaadha:ncn,yea dy larpu ndpusldtia noist mdgetiehelraenaertcstme ttsal a,y,pp n aapardnnert oidqdeba u netcchitthrhsteeee , f srstrot eeit mrXvfh ere-ieenr rr rafigstaeypy,lr, e raattachonnli e fddaia c tn rh yectdepyas mepurod elfootif safdeo cropyf s nfrc s ogapeobmuneplicteediecimraersa,ll iticzcntiooehaerndnes- s and Conditions (https://onlinelibrary.wiley.com Chapter 1 (Tools to diagnose cardiac conditions in children) includes sections on /term hccuaisrsCtdsoheiorasyg p,f rptuaehnpryc h2styii oc (aEannnla edvl xi mrcaoamunrrdmimniaeaucntr itosca.an ltA ,ah e nebldetreci egrtifrez ooanctveaieotrirdncv i,ioc eiogswn ri andopcifthl iusoypd,n eeascdn ai.dasl s cophcreoiasctte erddaud wrioeistgh,r ashupechahyr ,t aa sdn iedsec dhaisose-- s-and-conditions) on W in children) presents syndromes, genetic disorders, and maternal conditions com- iley O mc(tinaohcco-Cily lrndeeahflranyates opnasetth,sdie”scu ro p ns“acu tAn3i lamid–nnt7 eoo wcd mnah iatwriahelrdlyi i ter“n hbesCo n lcowrl”aomoi sntd(sahcgi lyff eilaabcon nalwloietotoai)fso,tldi -ns“h t foCwealo-aoni rwtrindhgtd ) hd,pii nttih“s icoseyCrhnsaeoiussaon ensolgo.etb egdisnny to r itocurah fcld itclheidnocergnreae gnrbate”l sond e(oiidatsdac ep lyaf ualhsonelemw oaw ortitininc t d hacair hsnyaeid l dabr isrlwgoeehnoi tit”nhd- nline Library for rules of use; O A fclhoawp)t,e arsn dd is“cUunssuessu sapl efcoirfmic sc oonf gceonnitgael nciatardl ihaec amrta dlfiosermasaet ioinn sc.h Tilhdere hne.”m Tohdiysn saemt viocisfi articles are governed by the applicable Creative Com m ons License D ow nloaded from viii Preface https://onlinelibrary.w oitmfnhrfoga aCCtmlsthfhh ,op e aater ehppmmlreettmaacee ftltrriefrit ooo89 tdarnc (mil(asUf Tft raheonldetre iiaiqeoto hdncugneaiternsi ar a agdcamlda iradteu,roc di laap t ic sganrcyoecndimrns o ccedcpusonhiitlntstaoei.edotsmdiintot issanor as.iann dcas iq toibhnugae irrns aeinespd wefh oodbsnru.o aurEritnnnmad gli pne pchrfehsaartnisialoditnssdh d)i osdian onepgdsdl c)at rhicininebe cd etplh usho edtyn hest esrifca eccanaaals trrfiudditniriioaaednccs- iley.com/doi/ by ibrahim ragab - Cochrane G problems, such as Kawasaki disease, rheumatic fever, and the cardiac manifesta- erm tions of systemic diseases which affect children. any , W Chapter 10 (Abnormalities of heart rate and conduction in children) presents iley O gdctcphuhiiacseCsiCtcals hduhhle orpsaase(psri ppnnaehptt.ccdeeyrlt.esurric ivdo1a1eilln2on1 g gt b(i (yvAaCc eas io rihnccniesusdgs al uaemlotetshfoats iy rnv ydfeal oii gfsarehueg sempcntahpyoerliosetlnd ir sttrfa eaondanifldenu c vdrwapiec rri edtemihsniva, ae canani n fnatafnigdnaiole ngurtmt rmrseha e aneiannlas ntp r hcdtl haeo dnaicfli dhrtstaerir lethad(inotysrhee.tn hen M)im )nt evr cadecodsaihctniti salmsdomli drreaedaennnjerotds)rs r s sid ttauhyirisr)nee--, nline Library on [23/11/2022]. See the Term ivtp“rneeaeAcansTdlddcauhiudaindinslticaitg rneibiro cg od inss coesiassmackule rt eardoiioesssik oanepnindl oaotgiahnrgt,tt agy iahct,”t uybhso pluseeareeb c rrcf osettottoemniirotn ducents ht hismeooi el nfad af c,oern teclxrhiino fpptee mihaw dsnetpbsi dt,iaomn hienon xaahykgendie nryunaicgn lriuet scthmsex lduoco, biedmoaseleendleer ad. n sbo cPeotohrf te ataahehvnrpelee detrn tec arretrtaliisrsnsodo okcnain ytf ndiiacaocdilncs on ctrdpatoeuh lesrhs esodsea euifanacodrl ddtcr.th d eec soixamt.tnir osdaTl inioinhonanee--l s and Conditions (https://onlinelibrary.w rtdeioiasCnogesun rrootcasceiecnsdu c groh.e noTn shetehernaree l tifbzooaa rbtseiieos, noonsffo agtt hrreaee la lm ctirenaistdsette rav.ina aI clnuse eepst e tofodof i rartcethara irdchd eeciarrasecr. .daioblnoogrym, aasli tiyn walill lf ibeled sc,o erxreccetply- iley.com/terms-and-conditions) on W iley O nline Library for rules of use; O A articles are governed by the applicable Creative Com m ons License D ow nloaded from https://onlinelibrary.w Chapter 1 iley.com Tools to diagnose cardiac /doi/ by ibrahim conditions in children ragab - Cochrane G erm HistGoeryn eral principles of the cardiovascular history 22 any , W Chief complaint and/or presenting sign 3 iley O PLahbyVCPAECPsoieluirabhcetarlaracdesctdltelsuoo rite saosmro ixysXcgcxai i ao-nneiemm rrnsxaxad aia leyn imom etarxgytiiannir oamaanpttii ihnooyann t ion 2233344990155569 nline Library on [23/11/2022]. See the Term AddBEMCCEicxltoaoaiheormogrdoncdnicpiaas aeuclce rtot r diceectuiea daornstd eghtttsiiosrennoa mtggpne oharingyz acraetip oihmny a ging and angiography 55555660188859 s and Conditions (https://onlinelibrary.w iley.com Much of the information presented in this chapter relates best to older infants and /term cbglehernoi lgvudeepresr,y n i en.ic l lDnh aeoianwcgdabn ridoonirs oninsgs e irnaear dpen h eodywf i siabsc nuoo srfunsteer gidnne fitnnahtn e Ctd shiin aaisigtp inmateol orsd ri8isea . gfdonifrof ipsctruiocltm ,m pbetet chtaroeudas.te mT thehene t u.p naInitq ieuthneit s c mhaagaley- s-and-conditions) on W The history and physical examination are the keystones for diagnosis of cardiac iley O phcaasrisosrtdebosilorseymvm aaessnnc. dutA loap vfrha styrhysieseictt eaypm la oet fiax eoarnemtt h’vsiein ecraw odtnieioaddngi,t. n iaoWonnsdit tc ihbca ynte ec abcochemh no bitqbeinutcaiehnisnng eic qtdahu.nee ,bd eda tiefafm edrpeerlnoivty eeadds,p abenec ytasoc ncoduf rttahhteee nline Library for rules of use; O MW© oa2llt0lee2rr’3 sH JE.o sJhsoenhn nWtisaoillsne y,o Jf&r .P Saeondndias tC rLiatcdm C. daPerudnbi olLis.lo hHgeeydb, 2sFo0on2u.3r t hb yE dJoithionn W. iley & Sons Ltd. 1 A articles are governed by the applicable Creative Com m ons License D ow nloaded from 2 Moller’s Essentials of Pediatric Cardiology https://onlinelibrary.w HGTheIenS sueTsrpOaiclRi opYnr ionf cai pcalredsio voafs ctuhlaer acbanrodrmioavliatys mcuayl abre hraiissetdo rinyitially by specific iley.com/doi/ by ibrahim scbEyavemrecdnapiu atcoswe mim tthshu, erbam m uustar i.glm fnMooirfarmiecn aaycnt oicto mhnci mladdrorodeneinalsy c w n topihttreh o rbepals reuecmaslter ,dn initta ihncme ga a bjcfoehnraio lthdrume rmmea loaiitsdyy y tnahbraeeem daaiicsss yycammoltvppeettrrooaytmm iooaafntt siiacc. ragab - Cochrane Germ because the myocardium is capable of responding normally to the stresses any , W pmmtoDyglpaiiyIgyanoce hg esoco tdafno b r tpfotduh ardipseoainato dlct iinnfacuoi g: bcni cte trdlt ho uhbitosseyieyioss meshtn.h i.spseutt ogoargmlyte esosr tfebi ndaeg cch ahaeui mlddsie oas gduonysfpno eacsciomst,ee ixcadisss .sot eeAfs nc sctam orcdemoniarptco ao ndrfaai ssbreeylae vsea elrrei,tt seyoir,on iaanenl isdnde ietsahkenesa satehedt iruoeolle-rt iley Online Library on [23/11/2022]. See the Term AtscDGithmtieearinlniegdaosdnrl eseomsinsrse,..otp ircatCe anc elldl irukd teaetersilfany ea n icnncstapd fr(o edAosmitSiathDaicoe l)ern m a mtoanholfdaf ron teprh miagent e aemgntnireoaetr lnaaedtsl u cfahhcartaictludvetoserr ier easnas r i. tn deoCcrecloiucfoiaudnsrureic tst emt a h(toPgieoDre enfnAo dco)ll eoofar mwt rhepmi nerte ogwadn.ooolry mt taioin,n aatmohnrracteelieec. s and Conditions (https://onlinelibrary.w Anogseti.c Tchluee a. gTeh ea tm wuhrmichu ras coafr cdoiancg menuirtmal uaro ortri ca sstyemnopstiosm an dde vpeulolmpos nmaaryy sgtievne oas idsi aagre- iley.com/term ouTAhfs tufeeua nnmll cyhut eifroimarnsrduat l rr o (eoinncfo n tagohnnce ei zAfneirStds)D t m b emeuxcaraammyu uisnnreo a itsto i ofbf onesu y adnmfidstpec itorno v bmaeitrrs te lheda.an suVdtne hmntiatl urlftirc hmoueflu a psrrc rhaesetso cpothtwla-o aloo gd wl eee efcxeehackimtlsd (iornVefaSn tDa.iog) neis.. s-and-conditions) on W iley O SIbEneetf iovsoroemluoragigtthiyyot. no tfh taht esu cgagredstisa tch ec oconnddiittiioonn’s severity (e.g. dyspnea or fatigue) should nline Library for rules of use; OA Ttihoen e(ex.agm. imneart esrhnoaul lldu pseues)k. information that suggests an etiology of cardiac condi- articles are governed by the applicable Creative Com m ons License D ow nloaded from 1 Tools to diagnose cardiac conditions in children 3 https://onlinelibrary.w CCdiehsrotiraedinfe r csp oraenmsde npthtliena g“i nicnotd meaxpn oladfi ns/otussr pa ipncdiro ensis”ge nansid tasi rtenh gem mosreiegd cincoaml pmroofne sisni opnaarlt iicnu olarrg acnarizdiinagc iley.com/doi/ by ibrahim tdamhcisoeuc rtuedes a lsditekayde sl tpyloa n ateme arrea, isknnueo l atna co padfr riebfdfvrieiaoorcneu nccshltayiiua ohlsl ieedtsiais al atgthrhneya o onfsof iotsue.f rn -Fc m oomron omngrteeahs n-tli oiykv leedol yfhi nettfhhaaarentn tsf iacgwailnuirtsdrh eia a)nn.c o dTc hamseuyrumseerfmpso tr(uoeerm., g iass. ragab - Cochrane G cdoiamgpnloestteic hsitsutodrieys mtou astr ribvee aint ttehger actoerdre cwt itcha rdthiaec pdhiaygsincoasl ise.xamination and other ermany , W The most common symptoms or signs found in an outpatient setting are mur- iley O mMMatishd uueauurirsrl,rmty scmlmi uhfwepreu titsiirtsomth mtp ehaa.ae itnCn imco,e rproamtasnatlaidp ncl i tomhfaemetuaiaomrtrmunto rsuhen,r as asp v anreared pesa pnenaenes aiastniorrnin-cn sgoiyga cnf tieaecnnofddttp ei wn(erng iit(o nfhbraf meaiancnnatac iluni)yn sg mnte)eo. uvncridremt nututoa rm l lbsyou eamr lmiln ecunthiormi;lc dteehr needtn u.c raThinnhildgde nline Library on [23/11/2022]. See the Term vmCCeisshhutiietermsms stta tuopt er paa doia n pfti oenAisd SoaiaDc tcc riuoiscr m o eanmmte ose oinrmmg apeenno dtcrit ymab rneeotn o iinegmx n7c 0iessp% yfmtoi orop nfct .ohsmcehs toi npo alo-ia lndg.eerd c chhilidldrerenn a. nAdb oaduot l1e since 2n0ts0, s and Conditions (https://onlinelibrary.w itdtfssrieuoicosvpChnopere.hrhra d mAeivceaseli trtncnchs pda tso(rayr eiudnico.nggiudot hr.hlrma ao Meprrmy reet aolareyrspicf csiogaha a(cntnyerhcdc s.suyga iyt)rr.oi ns dsmKf d wi maarai.oiwnayt Mmh fyall eacsceoamaaa)s dkrutmdm i sc tidaeohaoy ivtisc l itadehohrsaruenaecssve.une te l aOpa wwcnrach iigdittcnehhiainss, s teccaii toooa(. o isnrnsPoer ga aa nbdletllamyaiune,rc rinyotkic natsa)hslt g rp ceat wcaeaslhwitrrint dyihla dpifaa yrhacncosioo enmamnou s ndsaraayoe.lcof sccMcomritotariyimvsmctoe;e adcp dhttaia yisiwsronspdseniieuietcasrhes--,l iley.com/terms-and-conditions) on W including those who are fully recovered from surgery, do not have chest pain, and iley O mdfgsriouaooM simsns htioo n ec3st hd t0ah i n lfscadre hvourceeemlo nsnant a a adcrpnn asdagd rtiidi nsonait a darfiics oibbv lmueyeb t smeaticohnlefineniong .urat nmBstb.e ewsasIentt,hi nioagoicsnnn e p d u ocor serhlfuo s eddeacsiianlstaleyl tpip zawhteasroediiatn.rh n et iosscsii hesttn,ehy snpte,tai cppuaaaapslrliepynaa e swa,ta seere rmitlnnhl geaelos li ricaas acb,r hleraizuianeep.df d tI ctl,py oi,sas mhr ldeaapssirslttpathinii nneignt-- nline Library for rules of use; OA cohftaerna categrg r(navoat te“dcr ubsyh icnegrt”a ilnik ep oasnitgioinnas) ,o srh morot vienm deunrtast,i oann d(s eoccocnadsiso ntoa llmy icnaunt ebs)e, articles are governed by the applicable Creative Com m ons License D ow nloaded from 4 Moller’s Essentials of Pediatric Cardiology https://onlinelibrary.w iocwaPnanfadi ut clhuosphe crcegie thsfadaotinl drtwbi cihtyoa ho clpnelao at usdeplsp naceadih ntceei.aor sSnnnt one pomsoasvti.een b Tr.n ehBto heefnsoenec uiaa gncrrnhedd aai.pa.ra caBi cncet oenisnri giodsntfiitt ciecosnh na edsrs eet( e sspc.tgarrio.ibn nae gsmdt heaavmsyi d“aaef)lsu nmonc ceaot ycai ocgbunaerai nlaa”sss tsb aoce cacrireaadsutiueasdlect iley.com/doi/ by ibrahim ragab - Cochrane G Pmaolpniltya, tiroanpsid, thbee astesn, saarteio anl soof icrroemgumlaorn h iena rtthbee astcsh, o“oskl-ia pgpeedd bcheialdts ,a”n odr , amdoolrees ccoenmt-. ermany , W They frequently occur in patients with other symptoms, such as chest pain, but iley O ottksSoopnfyt raoeebnnwdnec o nondaf pso upastreor isens cimaingimang attuledtheludt e abr o ewnesr yeaitbmtothhe)u pa oasnttnlssooyd.tm r aw mPs.tuai atiPldchpl ad isilttepinahnnitettui aoo tsote nlirtroeshhm nryeoasitrn fh n aasmsryctueime o dwnnpd hotesoetun mngu ogssau.nen assP telael tytll pea (pcicattrhapreytopsiaocerraonnrrxhstdi ymiaitonrhag empt reoaailamftyti. ee tninhst esfm owtuoimninthdie- nline Library on [23/11/2022]. See the Term Sttaponohydrfeene nocas ecelnceeo,sya nssp wrcitptde,ear i intaoiothsertdl e oa ryaa gooes mymufas tdproecesdoln,r.i enen oLc nitceicaaf,cx,e rn butd-peert riraiohrneeecursfsne i seivlacn oenetr s etne ws dnca iouonoitnufrr v ikgurecne- porg ue.y n .ptWte sio.oxIc to Celi oo1rriarsgcu5ir isis%dseaoneis ame , c cosaooe sfrcrm e aahca sumihrnssasittooleroedecnscrri ie aefcbpontdauerr,elte d nsf es epywtsena opnsitcsttetuorhsiconrip ibelangoelslge sl, yi s, sns p y uaocdmanlcfulu phpdprdii t,otnae oawssg mtet iluhloat erhenctcaoneks-l s and Conditions (https://onlinelibrary.w tdctivnrooeiiofrchDnaymaid,necl isyltwt(ep oii. odhipeftneaie.ac ast tlhta.othh h lFniyset u,ghi secr yoctsoQnhou.nTderlcdo rrseo nycrbmannleurd e yaer e sos(xa SymapnInsDloeoc St mor[o)eLp, ad Qatlsh ilTwe feeSosisp,]mre ,i s asBmdouordiiudarnetggdgi coane dnfodsta seetde)ean senat hganomstedsh,nai s,syea, t rnsrcaypudotnuc emctlssmuoie,n rp bogafeenrll ,eona( -hmisr ogyey cn pitzc hheeuuyertrptpi eorafeosaln,orpm ttgshe iuimnilecydss oidc hoataeionrsrne--r) iley.com/terms-and-conditions) on W often the culprit, with vasovagal syncope being the most common pediatric iley O daesWsiiumigoaitnntgoohi ntnf aiiaooocn sanfmdianas li tllct (hu t>cnoepe8e srt0rehpev%bteao,r t uga iwesorl n oiftshtu hy ypsn qpttedheuod,emip cig aekr rteorlaryfsvivu cueir stlretiysro ay ebnnwnaeo,cc ia notllkesogpe ant endbog)sir. en a.a rVg d Ftha yrutiiscgnrooatgd hvrledeaoerrigrs,as sa sh ralueo inscssftdth yooc/n oraorcyarsno t vsdopioacebeinsoh to aouyodidcsfni nclrecaaueedttrsiri osseof nbrnwao r,naa mhpndle a dp ntit enho trh,etnf husoueees-r. nline Library for rules of use; OA pchaatinegnets otyrp ipcarolllyo ningceludd eusp irnigahdte qbuoadtey fpluoidsi taionnd, saalnt di,n taimkep,o prtraencteldy,i npgr opdorsotumraall articles are governed by the applicable Creative Com m ons License