Pediatric cardiology : the essential pocket guide PDF
Preview Pediatric cardiology : the essential pocket guide
Pediatric Cardiology TheEssentialPocketGuide Pediatric Cardiology The Essential Pocket Guide THIRD EDITION Walter H. Johnson, Jr., MD ProfessorofPediatrics DepartmentofPediatrics DivisionofPediatricCardiology UniversityofAlabamaatBirmingham Birmingham,AL,USA James H. Moller, MD ProfessorEmeritusofPediatrics AdjunctProfessorofMedicine UniversityofMinnesotaMedicalSchool Minneapolis,MN,USA Thiseditionfirstpublished2014 ©2014byJohnWiley&Sons,Ltd ©2008byBlackwellPublishingLtd Registeredoffice:JohnWiley&Sons,Ltd,TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK Editorialoffices:9600GarsingtonRoad,Oxford,OX42DQ,UK TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK 111RiverStreet,Hoboken,NJ07030-5774,USA Fordetailsofourglobaleditorialoffices,forcustomerservicesandforinformationabouthowtoapplyforpermission toreusethecopyrightmaterialinthisbookpleaseseeourwebsiteatwww.wiley.com/wiley-blackwell TherightoftheauthortobeidentifiedastheauthorofthisworkhasbeenassertedinaccordancewiththeUK Copyright,DesignsandPatentsAct1988. Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,ortransmitted,inany formorbyanymeans,electronic,mechanical,photocopying,recordingorotherwise,exceptaspermittedbytheUK Copyright,DesignsandPatentsAct1988,withoutthepriorpermissionofthepublisher. Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedastrademarks.Allbrandnamesand productnamesusedinthisbookaretradenames,servicemarks,trademarksorregisteredtrademarksoftheir respectiveowners.Thepublisherisnotassociatedwithanyproductorvendormentionedinthisbook.Itissoldonthe understandingthatthepublisherisnotengagedinrenderingprofessionalservices.Ifprofessionaladviceorother expertassistanceisrequired,theservicesofacompetentprofessionalshouldbesought. Thecontentsofthisworkareintendedtofurthergeneralscientificresearch,understanding,anddiscussiononlyand arenotintendedandshouldnotberelieduponasrecommendingorpromotingaspecificmethod,diagnosis,or treatmentbyhealthsciencepractitionersforanyparticularpatient.Thepublisherandtheauthormakeno representationsorwarrantieswithrespecttotheaccuracyorcompletenessofthecontentsofthisworkand specificallydisclaimallwarranties,includingwithoutlimitationanyimpliedwarrantiesoffitnessforaparticular purpose.Inviewofongoingresearch,equipmentmodifications,changesingovernmentalregulations,andthe constantflowofinformationrelatingtotheuseofmedicines,equipment,anddevices,thereaderisurgedtoreview andevaluatetheinformationprovidedinthepackageinsertorinstructionsforeachmedicine,equipment,ordevice for,amongotherthings,anychangesintheinstructionsorindicationofusageandforaddedwarningsand precautions.Readersshouldconsultwithaspecialistwhereappropriate.ThefactthatanorganizationorWebsiteis referredtointhisworkasacitationand/orapotentialsourceoffurtherinformationdoesnotmeanthattheauthoror thepublisherendorsestheinformationtheorganizationorWebsitemayprovideorrecommendationsitmaymake. Further,readersshouldbeawarethatInternetWebsiteslistedinthisworkmayhavechangedordisappearedbetween whenthisworkwaswrittenandwhenitisread.Nowarrantymaybecreatedorextendedbyanypromotional statementsforthiswork.Neitherthepublishernortheauthorshallbeliableforanydamagesarisingherefrom. LibraryofCongressCataloging-in-PublicationData Johnson,WalterH.,Jr.,author. Pediatriccardiology:theessentialpocketguide/WalterH.JohnsonJr.,JamesH.Moller.–Thirdedition. p.;cm. Includesbibliographicalreferencesandindex. ISBN978-1-118-50340-9(pbk.) I.Moller,JamesH.,1933–author.II.Title. [DNLM:1.HeartDiseases–Handbooks.2.Child.WS39] RJ421 618.92′12–dc23 2013043842 AcataloguerecordforthisbookisavailablefromtheBritishLibrary. Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappearsinprintmaynotbe availableinelectronicbooks. Coverimage:courtesyofRobbL.Romp,M.D. CoverdesignbyAndyMeaden Setin8/10ptFrutigerLightbyLaserwordsPrivateLimited,Chennai,India 1 2014 Contents Preface,vii 1. Toolstodiagnosecardiacconditionsinchildren,1 2. Environmentalandgeneticconditionsassociatedwithheartdiseasein children,73 3. Classificationandphysiologyofcongenitalheartdiseaseinchildren,86 4. Anomalieswithaleft-to-rightshuntinchildren,95 5. Conditionsobstructingbloodflowinchildren,148 6. Congenitalheartdiseasewitharight-to-leftshuntinchildren,186 7. Unusualformsofcongenitalheartdiseaseinchildren,233 8. Uniquecardiacconditionsinnewborninfants,245 9. Thecardiacconditionsacquiredduringchildhood,259 10. Abnormalitiesofheartrateandconductioninchildren,291 11. Congestiveheartfailureininfantsandchildren,315 12. Ahealthylifestyleandpreventingheartdiseaseinchildren,329 Additionalreading,373 Index,375 v Preface Since the first printing of this text 50 years ago, pediatric cardiac catheteriza- tion,echocardiography,andmagneticresonanceimaginghavedevelopedandless emphasishasbeenplacedonthemoretraditionalmethodsofevaluatingacardiac patient.Mostpractitioners,however,donothaveaccesstotheserefineddiagnos- tictechniquesorthetrainingtoapplythem.Toevaluateapatientwithafinding thatcouldsuggestacardiacissue,apractitionerthereforereliesuponeitherthe combinationofphysicalexamination,electrocardiogram,andchestX-ray,orrefer- raltoacardiacdiagnosticcenter. This book formulates guidelines by which a practitioner, medical student, or houseofficercanapproachthediagnosticproblempresentedbyaninfantorchild withacardiacfinding.Throughproperassessmentandintegrationofthehistory, physical examination, electrocardiogram, and chest X-ray, the type of problem canbediagnosedcorrectlyinmanypatients,andtheseverityandhemodynamics correctlyestimated. Eventhoughapatientmayultimatelyrequirereferraltoacardiaccenter,the practitionerwillappreciateandunderstandbetterthespecifictypeofspecialized diagnosticstudiesperformed,andtheapproach,timing,andresultsofoperation ormanagement.Thisbookhelpsselectpatientsforreferralandoffersguidelines fortimingofreferrals. Thebookhas12chapters: Chapter1(Toolstodiagnosecardiacconditionsinchildren)includessections onhistory,physicalexamination,electrocardiography,andchestradiography,and discusses functional murmurs. A brief overview of special procedures, such as echocardiographyandcardiaccatheterization,isincluded. Chapter2(Environmentalandgeneticconditionsassociatedwithheartdisease inchildren)presentssyndromes,geneticdisorders,andmaternalconditionscom- monlyassociatedwithcongenitalheartdisease. Chapters3to7are“Classificationandphysiologyofcongenitalheartdiseasein children,”“Anomalieswithaleft-to-rightshuntinchildren”(acyanoticandwith increasedpulmonarybloodflow),“Conditionsobstructingbloodflowinchildren” (acyanoticandwithnormalbloodflow),“Congenitalheartdiseasewitharight- to-leftshuntinchildren”(cyanosiswithincreasedordecreasedpulmonaryblood flow), and “Unusual forms of congenital heart disease in children.” This set of chapters discusses specific congenital cardiac malformations. The hemodynam- icsofthemalformationsarepresentedasabasisforunderstandingthephysical vii viii Preface findings,electrocardiogram,andchestradiographs.Emphasisisplacedonfeatures thatpermitdifferentialdiagnosis. Chapter8(Uniquecardiacconditionsinnewborninfants)describesthecardiac malformationsleadingtosymptomsintheneonatalperiodandinthetransition fromthefetaltotheadultcirculation. Chapter9(Thecardiacconditionsacquiredduringchildhood)includescardiac problems,suchasKawasakidisease,rheumaticfever,andthecardiacmanifesta- tionsofsystemicdiseaseswhichaffectchildren. Chapter10(Abnormalitiesofheartrateandconductioninchildren)presents thepracticalbasicsofdiagnosisandmanagementofrhythmdisordersinchildren. Chapter 11 (Congestive heart failure in infants and children) considers the pathophysiology and management of cardiac failure in children. Medical and surgical(includingtransplantation)treatmentsarediscussed. Chapter 12 (A healthy lifestyle and preventing heart disease in children) dis- cussespreventiveissuesforchildrenwithanormalheart(thevastmajority),includ- ingsmoking,hypertension,lipids,exercise,andotherriskfactorsforcardiovascular diseasethatbecomemanifestinadulthood.Preventionandhealthmaintenance issuesparticulartochildrenwithheartdiseasearealsodiscussed. Thisbookisnotasubstituteforthemanyexcellentandencyclopedictextson pediatriccardiology,orfortheexpandingnumberofelectronicresources.Theref- erencessectionsaccompanyingsomechaptersandtheadditionalreadingsection attheendofthebookincludebothtraditionalandonlineresourceschosentobe ofgreatestvaluetoreaders. Certaingeneralizationsaremade.Inpediatriccardiology,asinallfields,excep- tions occur. Therefore, not all instances of cardiac abnormality will be correctly diagnosedonthebasisofthecriteriasetforthhere.
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