C Common Common Cardiac o m Issues in Pediatrics m o Cardiac Issues n Editors C Jonathan N. Johnson, MD, FACC, FAAP, and a r in Pediatrics Deepak M. Kamat, MD, PhD, FAAP d i a c Learn from leading experts the latest information on cardiac I issues that present most often in a pediatric office. The s scope of focus includes signs and symptoms, management s u of patients with acquired or congenital heart disease, c ardiac e implications of common infectious diseases, preventive s cardiology, and other issues that are frequently managed or i n evaluated by the primary care pediatrician. P Topics include e d • Electrocardiography i a • Heart Murmur t r • Syncope i c • Cardiomyopathies and Channelopathies s • Rheumatic Heart Disease • Endocarditis J O • Cardiac Pharmacology H N S • Transition From Pediatric to Adult-Centered O N Cardiac Care ∞ K Editors A M For other pediatric resources, visit the Jonathan N. Johnson, MD, FACC, FAAP A T American Academy of Pediatrics Deepak M. Kamat, MD, PhD, FAAP at shop.aap.org. ISBN 978-1-61002-144-9 90000> 9 781610 021449 AAP Common_Cardiac_issues_cover-spread_final.indd 1 3/13/18 3:31 PM Common Cardiac Issues in Pediatrics Editors Jonathan N. Johnson, MD, FACC, FAAP Deepak M. Kamat, MD, PhD, FAAP CCIP.indb 1 3/13/18 4:18 PM American Academy of Pediatrics Publishing Staff Mark Grimes, Vice President, Publishing Chris Wiberg, Senior Editor, Professional/Clinical Publishing Theresa Wiener, Production Manager, Clinical and Professional Publications Heather Babiar, Medical Copy Editor Peg Mulcahy, Manager, Art Direction and Production Mary Lou White, Chief Product and Services Officer/SVP, Membership, Marketing, and Publishing Mary Louise Carr, MBA, Marketing Manager, Clinical Publications 345 Park Blvd Itasca, IL 60143 Telephone: 630/626-6000 Facsimile: 847/434-8000 www.aap.org The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of care. 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No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or otherwise—without prior written permission from the publisher (locate title at http://ebooks. aappublications.org and click on © Get Permissions; you may also fax the permissions editor at 847/434-8780 or e-mail [email protected]). Printed in the United States of America 9-389/0418 1 2 3 4 5 6 7 8 9 10 MA0857 ISBN: 978-1-61002-144-9 eBook: 978-1-61002-145-6 EPUB: 978-1-61002-237-8 Mobi: 978-1-61002-238-5 Library of Congress Control Number: 2017940294 CCIP.indb 2 3/13/18 4:18 PM COMMON CARDIAC ISSUES IN PEDIATRICS Editors Jonathan N. Johnson, MD, FACC, FAAP Deepak M. Kamat, MD, PhD, FAAP Associate Professor of Pediatrics Professor of Pediatrics Chair, Division of Pediatric Cardiology Vice Chair for Education Department of Pediatric and Adolescent The Carman and Ann Adams Department Medicine of Pediatrics Mayo Clinic Wayne State University Rochester, MN Designated Institutional Official Children’s Hospital of Michigan Detroit, MI Contributing Authors Sanjeev Aggarwal Heather Anderson, MD, FAAP Professor of Pediatrics Fellow Division of Pediatric Cardiology Division of Pediatric Cardiology Children’s Hospital of Michigan Mayo Clinic Wayne State University Rochester, MN Detroit, MI Ch 19: Congenital Heart Lesions Ch 8: Chest Pain Kristin Anton, RN, MSM, CPNP-AC Huzaifa Ahmad, MBBS Children’s Health MBBS Class of 2018 Dallas, TX The Aga Khan University Ch 44: Pulmonary Hypertension Karachi, Pakistan Neha Bansal, MD Ch 14: Neonatal Screening for Heart Disease Fellow Pediatric Cardiology Kiona Y. Allen, MD Children’s Hospital of Michigan Assistant Professor of Pediatrics Detroit, MI Northwestern University Feinberg School Ch 8: Chest Pain of Medicine Dianna M. E. Bardo, MD, FSCCT, FNASCI Ann and Robert H. Lurie Children’s Hospital Director, Body MRI of Chicago Co-Director, 3D Innovation Lab Chicago, IL Department of Medical Imaging Ch 39: Neurodevelopmental and Psychosocial Phoenix Children’s Hospital Outcomes in Children With Congenital Clinical Professor of Radiology and Heart Disease Child Health Carolyn A. Altman, MD, FAAP University of Arizona Associate Chief, Pediatric Cardiology Phoenix, AZ Professor, Pediatrics Ch 5: Chest Radiography Baylor College of Medicine Sarosh P. Batlivala, MD, MSCI, FAAP Texas Children’s Hospital Associate Professor, Pediatric Cardiology Houston, TX Associate Program Director, Pediatric Ch 31: Prevention of Bacterial Endocarditis Cardiology Fellowship Ch 33: Pericardial Diseases Director, Pediatric Fellowship Training Ahdi Amer, MD Programs Associate Professor of Pediatrics The Children’s Heart Center The Carman and Ann Adams Department Blair E. Batson Hospital for Children of Pediatrics University of Mississippi Medical Center Wayne State University School of Medicine Jackson, MS Detroit, MI Ch 19: Congenital Heart Lesions Ch 28: Vaccines for Patients With Cardiac Conditions iii CCIP.indb 3 3/13/18 4:18 PM COMMON CARDIAC ISSUES IN PEDIATRICS Allison K. Black, MD Kanupriya Chaturvedi, MD, FAAP Pediatric Cardiology Fellow Fellow, Pediatric Cardiology University of Pittsburgh The Congenital Heart Collaborative Pittsburgh, PA University Hospitals, Rainbow Babies and Ch 38: Autonomic Dysfunction Children’s Hospital Jessica Bowman, MD Cleveland, OH Attending Pediatric Cardiologist Ch 36: Cardiac Screening Prior to ADHD Nationwide Children’s Hospital Treatment Assistant Professor of Pediatrics Sharon Chen, MD, MPH The Ohio State University Clinical Assistant Professor Columbus, OH Pediatric Heart Failure and Transplantation Ch 40: Lifestyle Counseling Lucile Packard Children’s Hospital at Stanford Harold M. Burkhart, MD University Professor and Chief Palo Alto, CA Department of Surgery Ch 43: Cardiac Transplantation Division of Thoracic and Cardiovascular Surgery Devyani Chowdhury, MD, FAAP, FACC University of Oklahoma Health Sciences Center Director, Cardiology Care for Children Oklahoma City, OK Affiliate Faculty Children’s Hospital Ch 16: Office Care of the Child After Cardiac of Philadelphia Surgery Lancaster, PA Ryan Butts, MD Ch 14: Neonatal Screening for Heart Disease Assistant Professor of Pediatrics Jason Cole, MD Division of Pediatric Cardiology PGY-3 Pediatric Resident University of Texas Southwestern UN Nationwide Children’s Hospital/Ohio State Dallas, TX University Ch 32: Myocarditis Columbus, OH Michael U. Callaghan, MD Ch 40: Lifestyle Counseling Associate Professor of Pediatrics Michael Colon, MD Children’s Hospital of Michigan Clinical Associate Professor of Pediatrics Detroit, MI Division of Pediatric Cardiology Ch 27: Cardiotoxicity Among Survivors of Albany Medical College Childhood Cancer Albany, NY Bryan Cannon, MD, FACC, FHRS, FAAP Ch 29: Lyme Carditis Director, Pediatric Electrophysiology John Colquitt, MD, FAAP Director, Pediatric Cardiology Fellowship Assistant Professor of Pediatrics Program Division of Pediatric Cardiology Associate Professor of Pediatrics Baylor College of Medicine Mayo Clinic Texas Children’s Hospital Rochester, MN Houston, TX Ch 37: Cardiac Screening for Athletic Participation Ch 31: Prevention of Bacterial Endocarditis Chesney Castleberry, MD Bibhuti B. Das, MD, FAAP, FACC Assistant Professor, Pediatric Cardiology Pediatric Heart Failure and Transplant School of Medicine, Washington University in Cardiologist St Louis Joe DiMaggio Children’s Hospital St Louis Children’s Hospital Memorial Health Care St Louis, MO Hollywood, FL Ch 22: Restrictive Cardiomyopathy Ch 44: Pulmonary Hypertension iv CCIP.indb 4 3/13/18 4:18 PM COMMON CARDIAC ISSUES IN PEDIATRICS Pirooz Eghtesady, MD, PhD, FAAP Julie Glickstein, MD, FACC, FAAP Professor and Emerson Chair Professor of Pediatrics at Columbia University Department of Surgery Medical Center Chief, Pediatric Cardiac Surgery Director, Pediatric Cardiology Fellowship Washington University in St Louis Program Co-Director of the Heart Center Department of Pediatrics/Division of Pediatric St Louis Children’s Hospital Cardiology St Louis, MO Morgan Stanley Children’s Hospital of New Ch 15: Surgical Procedures for Congenital York Presbyterian Heart Disease New York, NY Noelle Andrea V. Fabie, MD Ch 12: Evaluation of the Neonate With Congenital Medical Biochemical Fellow Heart Disease Division of Genetic, Genomic, and Metabolic David J. Goldberg, MD Disorders Assistant Professor Children’s Hospital of Michigan Department of Pediatrics Detroit, MI The Perelman School of Medicine at The Ch 17: Common Syndromes Associated With University of Pennsylvania Cardiac Lesions Division of Cardiology Swati Garekar, BC The Children’s Hospital of Philadelphia Director, Pediatric Cardiology Program Philadelphia, PA Fortis Hospital, Mulund Ch 7: Laboratory Studies Mumbai, India Pooja Gupta, MD, FASE, FACC Ch 26: Acute Rheumatic Fever and Rheumatic Assistant Professor of Pediatrics Heart Disease Division of Pediatric Cardiology Bessey Geevarghese, DO Children’s Hospital of Michigan Assistant Professor Wayne State University Northwestern University Feinberg School Detroit, MI of Medicine Ch 9: Syncope Attending Physician, Division of Infectious Caitlin Haxel, MD Disease Chief Fellow, Pediatric Cardiology Ann and Robert H. Lurie Children’s Hospital Division of Pediatric Cardiology of Chicago New York Presbyterian—Morgan Stanley Chicago, IL Children’s Hospital Ch 25: Kawasaki Disease Columbia University College of Physicians Miwa Geiger, MD and Surgeons Assistant Professor of Pediatrics New York, NY Division of Pediatric Cardiology Ch 12: Evaluation of the Neonate With Congenital Director, Fetal Heart Program Heart Disease Icahn School of Medicine at Mount Sinai Gurumurthy Hiremath, MD, FACC New York, NY Assistant Professor of Pediatrics Ch 41: Cardiac Pharmacology Division of Pediatric Cardiology Samuel S. Gidding, MD University of Minnesota Cardiology Division Head Minneapolis, MN Nemours Cardiac Center Ch 1: Clinical History and Physical Examination Professor of Pediatrics Ch 11: Heart Murmur Sidney Kimmel Medical College of Thomas Whitnee Hogan, MD Jefferson University Pediatric Cardiology Fellow Wilmington, DE Department of Pediatrics Ch 34: Dyslipidemia University of Utah Salt Lake City, UT Ch 20: Hypertrophic Cardiomyopathy v CCIP.indb 5 3/13/18 4:18 PM COMMON CARDIAC ISSUES IN PEDIATRICS Kelley K. Hutchins, DO, MPH Sonya Kirmani, MD Pediatric Hematology/Oncology Fellow Instructor, Pediatric Heart Failure/Transplant Children’s Hospital of Michigan Division of Pediatric Cardiology Detroit, MI Duke University Medical Center Ch 27: Cardiotoxicity Among Survivors of Durham, NC Childhood Cancer Ch 22: Restrictive Cardiomyopathy Anitha S. John, MD, PhD Stacie Knutson, MD Director, Washington Adult Congenital Assistant Professor of Pediatrics Heart Program Division of Pediatric Cardiology Children’s National Medical Center and University of Minnesota Washington Hospital Center Minneapolis, MN Assistant Professor of Pediatrics Ch 1: Clinical History and Physical Examination George Washington University Ch 11: Heart Murmur Washington, DC William Buck Kyle, MD, FAAP Ch 18: Adults With Congenital Heart Disease Assistant Professor of Pediatrics Jonathan N. Johnson, MD, FACC, FAAP Division of Pediatric Cardiology Associate Professor of Pediatrics Baylor College of Medicine/Texas Children’s Chair, Division of Pediatric Cardiology Hospital Department of Pediatric and Adolescent Houston, TX Medicine Ch 19: Congenital Heart Lesions Mayo Clinic Timothy S. Lancaster, MD Rochester, MN Fellow in Cardiothoracic Surgery Ch 4: Basics of Exercise Testing Barnes-Jewish/St Louis Children’s Hospitals Joyce Johnson, MD, MS, FAAP Washington University School of Medicine Assistant Professor, Pediatric Cardiology St Louis, MO Ann & Robert H. Lurie Children’s Hospital Ch 15: Surgical Procedures for Congenital of Chicago Heart Disease Northwestern University Feinberg School of Diego Lara, MD, MPH Medicine Pediatric and Fetal Cardiology Chicago, IL Ochsner Hospital for Children Ch 19: Congenital Heart Lesions Senior Lecturer Beth D. Kaufman, MD University of Queensland-Ochsner Clinical Clinical Associate Professor of Pediatrics School Director, Pediatric Cardiomyopathy Program New Orleans, LA Lucile Packard Children’s Hospital, Stanford Ch 33: Pericardial Diseases University Shannon Lyon, DO Palo Alto, CA University of Louisville Ch 43: Cardiac Transplantation Department of Pediatrics Angela M. Kelle, MD, FACC, FAAP Louisville, KY Assistant Professor of Pediatrics Ch 21: Dilated Cardiomyopathy Penn State Children’s Hospital Nicolas L. Madsen, MD, MPH Hershey, PA Medical Director, Inpatient Cardiology Ch 3: The Role of Echocardiography Assistant Professor of Pediatrics Steven J. Kindel, MD University of Cincinnati College of Medicine Assistant Professor of Pediatrics Cincinnati Children’s Hospital Medical Center Medical Director of Advanced Heart Failure Cincinnati, OH and Heart Transplantation Ch 19: Congenital Heart Lesions Herma Heart Center Children’s Hospital of Wisconsin Medical College of Wisconsin Milwaukee, WI Ch 23: Noncompaction Cardiomyopathy vi CCIP.indb 6 3/13/18 4:18 PM COMMON CARDIAC ISSUES IN PEDIATRICS Bradley S. Marino, MD, MPP, MSCE, FAAP Mark D. Norris, MD, MS Professor Pediatrics and Medical Social Sciences Medical Co-Director Adult Congenital Heart Northwestern University Feinberg School Program of Medicine University of Michigan Heart Center Co-Director, Research and Ann Arbor, MI Academic Affairs Ch 42: Transition and Transfer From Pediatric to Divisions of Cardiology and Critical Care Adult-Centered Cardiac Care Medicine Todd T. Nowlen, MD, FACC Ann & Robert H. Lurie Children’s Hospital Director Ambulatory Cardiology of Chicago Phoenix Children’s Hospital Chicago, IL Phoenix, AZ Ch 39: Neurodevelopmental and Psychosocial Ch 5: Chest Radiography Outcomes in Children With Congenital Brandon Lane Phillips, MD, FAAP Heart Disease Department of Pediatrics Daniel Mauriello, MD Ochsner Health Center for Children Assistant Professor of Pediatrics Monroe, Ochsner Clinic Foundation Division of Pediatric Cardiology West Monroe, LA Johns Hopkins All Children’s Hospital Ch 1: Clinical History and Physical Examination St Petersburg, FL Adam Putschoegl, DO, FAAP Ch 2: Electrocardiography Pediatric Cardiology Fellow Shaji C. Menon, MD, FACC, FASE, FAAP Division of Pediatric Cardiology Associate Professor of Pediatrics Mayo Clinic Adjunct Associate Professor of Radiology Rochester, MN Medical Director, Single Ventricle Survivorship Ch 19: Congenital Heart Lesions Program Ch 42: Transition and Transfer From Pediatric to University of Utah Adult-Centered Cardiac Care Salt Lake City, UT Muhammad Yasir Qureshi, MBBS, FASE Ch 6: Cardiac MR Imaging and CT Senior Associate Consultant James H. Moller, MD, FAAP Pediatric Cardiology Professor Emeritus and Former Head of Assistant Professor of Pediatrics Pediatrics Mayo Clinic College of Medicine Adjunct Professor of Pediatrics Rochester, MN Minneapolis, MN Ch 3: The Role of Echocardiography Ch 13: Fetal and Newborn Transitional Hari Rajagopal, MD Circulations Pediatric Cardiology Advanced Imaging Fellow Brandon Morrical, MD, FAAP Division of Pediatric Cardiology Instructor of Pediatrics Icahn School of Medicine at Mount Sinai Division of Pediatric Cardiology New York, NY Mayo Clinic Ch 41: Cardiac Pharmacology Rochester, MN Rini Sahewalla, MD Ch 4: Basics of Exercise Testing Fellow, Pediatric Cardiology Kathleen A. Mussatto, PhD, RN Children’s Hospital of Michigan Co-Director of Cardiac Research Detroit, MI Associate Clinical Professor of Surgery Ch 17: Common Syndromes Associated With Children’s Hospital of Wisconsin Cardiac Lesions Milwaukee, WI Amy H. Schultz, MD, MSCE, FACC, FAAP Ch 39: Neurodevelopmental and Psychosocial Attending Cardiologist Outcomes in Children With Congenital Seattle Children’s Hospital Heart Disease Associate Professor of Pediatrics Division of Cardiology University of Washington School of Medicine Seattle, WA Ch 30: Endocarditis vii CCIP.indb 7 3/13/18 4:18 PM COMMON CARDIAC ISSUES IN PEDIATRICS Kristen Sexson Tejtel, MD, PhD, MPH, Joshua D. Sparks, MD FAAP Director, Pediatric Advanced Heart Failure Assistant Professor of Pediatrics and Transplantation Director, Center for Preventive Cardiology University of Louisville School of Medicine Texas Children’s Hospital Norton Children’s Hospital Baylor College of Medicine Louisville, KY Houston, TX Ch 21: Dilated Cardiomyopathy Ch 35: Hypertension Ch 38: Autonomic Dysfunction Stanford T. Shulman, MD, FAAP Rachel Steury, MSN, CNP Virginia H. Rogers Professor of Pediatric Washington, Adult Congenital Heart Program Infectious Diseases Children’s National Health System Northwestern University Feinberg School Washington, DC of Medicine Ch 18: Adults With Congenital Heart Disease Division Head Emeritus Infectious Diseases David W. Stockton, MD, FACMG Ann and Robert H. Lurie Children’s Hospital Professor of Pediatrics and Internal Medicine of Chicago Chief, Division of Genetic, Genomic and Chicago, IL Metabolic Disorders Ch 25: Kawasaki Disease Wayne State University and Children’s Hospital Nikki M. Singh, MD of Michigan Pediatric Cardiology Fellow Detroit, MI Medical College of Wisconsin Ch 17: Common Syndromes Associated With Children’s Hospital of Wisconsin Cardiac Lesions Milwaukee, WI Alex J. Thompson, MD, FAAP Ch 23: Noncompaction Cardiomyopathy Department of Pediatric and Adolescent Lalitha Sivaswamy, MD Medicine Associate Professor of Pediatrics and Neurology Division of Pediatric Cardiology Carmen and Ann Adams Department Mayo Clinic of Pediatrics Rochester, MN Wayne State University School of Medicine Ch 19: Congenital Heart Lesions Detroit, MI Jess Thompson, MD, MSc Ch 9: Syncope Assistant Professor of Surgery Melissa Smith-Parrish, MD Section of Congenital Heart Surgery Assistant Professor of Pediatrics University of Oklahoma Northwestern University Feinberg School Oklahoma City, OK of Medicine Ch 16: Office Care of the Child After Cardiac Chicago, IL Surgery Ch 39: Neurodevelopmental and Psychosocial Bhadra Trivedi, MD Outcomes in Children With Congenital Pediatrics, Fellow, Pediatric Cardiology Heart Disease Department of Pediatric Cardiology Brian S. Snarr, MD, PhD Fortis Child Heart Mission Cardiology Fellow Fortis Hospital Mulund Division of Cardiology Mumbai, India The Children’s Hospital of Philadelphia Ch 26: Acute Rheumatic Fever and Rheumatic Philadelphia, PA Heart Disease Ch 7: Laboratory Studies Juan Villafañe, MD, FAAP Christopher Snyder, MD, FAAP Professor of Pediatrics Cardiology Ch 36: Cardiac Screening Prior to ADHD University of Kentucky Treatment Lexington, KY Ch 24: Long QT Syndrome and Other Channelopathies viii CCIP.indb 8 3/13/18 4:18 PM COMMON CARDIAC ISSUES IN PEDIATRICS Philip L. Wackel, MD Melissa Yamauchi, MD, MPH Assistant Professor of Pediatrics University of Utah Division of Pediatric Cardiology Salt Lake City, UT Mayo Clinic College of Medicine Ch 6: Cardiac MR Imaging and CT Rochester, MN Ch 10: Palpitations and Arrhythmia American Academy of Josh Weldin, MD Pediatrics Reviewers Assistant Professor of Pediatrics Division of Pediatric Cardiology Section on Cardiology and Cardiac Surgery University of Washington School of Medicine Section on Clinical Pharmacology and Seattle Children’s Hospital Therapeutics Seattle, WA Section on Infectious Diseases Ch 30: Endocarditis Section on Medicine—Pediatrics Don P. Wilson, MD, FNLA Diplomate, American Board of Clinical Lipidology Endowed Chair, Pediatric Cardiovascular Health and Risk Prevention Pediatric Endocrinology and Diabetes Cook Children’s Medical Center Fort Worth, TX Ch 34: Dyslipidemia ix CCIP.indb 9 3/13/18 4:18 PM