Related Experiment Video
Updated: Feb 1, 2026
Breath Collection from Children for Disease Biomarker Discovery
Published on: February 14, 2019
Characterization of Post-Thrombotic Syndrome in Children with Cardiac Disease
Cedric Manlhiot1, Brian W McCrindle1, Suzan Williams2
1Labatt Family Heart Centre, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.
Insights
The modified Villalta Scale (MVS) can reliably screen children for post-thrombotic syndrome (PTS), especially those with congenital heart disease (CHD). However, it shows a high false-positive rate and requires further study for accurate diagnosis.
Area of Science:
- Pediatric Cardiology
- Vascular Medicine
- Clinical Diagnostics
Background:
- Post-thrombotic syndrome (PTS) is a complication of deep vein thrombosis (DVT).
- Accurate diagnosis of PTS in children, particularly those with congenital heart disease (CHD), is challenging.
- Existing clinical scales need validation for pediatric populations.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the modified Villalta Scale (MVS) for PTS in children.
- To assess the MVS's utility in children with CHD, with and without a history of DVT.
- To examine the relationship between PTS, neurodevelopmental outcomes, and quality of life in pediatric patients.
Main Methods:
- A cohort of 100 children (>2 years) including those with CHD/DVT, CHD/no DVT, and healthy controls were assessed using the MVS.
- Neurodevelopmental testing and quality of life assessments were performed for children under 6 years.
- MVS results were compared against clinical diagnoses and validated for reliability and accuracy.
Main Results:
- The MVS identified mild to moderate PTS in 20 children, with 14 cases in the CHD/DVT group.
- The MVS demonstrated 91% accuracy as a screening tool but was less effective for definitive diagnosis.
- Children with PTS showed significantly higher rates of neurodevelopmental delays in gross motor skills and problem-solving.
Conclusions:
- The MVS is a feasible and reliable tool for screening pediatric PTS, including in children with CHD.
- The scale shows good correlation with clinical PTS diagnosis but has a notable false-positive rate.
- Further research is necessary to clarify the clinical significance of PTS in this pediatric population.
Objective:
To assess the validity of existing clinical scales assessing the presence of physical and functional abnormalities for diagnosing post-thrombotic syndrome (PTS) in children, including specific evaluation of use in children with congenital heart disease (CHD).
Study Design:
One hundred children aged >2 years (average age, 6 years), including 33 with CHD and previously proven extremity deep vein thrombosis (DVT), 37 with CHD and no previous DVT, and 30 healthy siblings, were blindly assessed for PTS using the modified Villalta Scale (MVS). All patients aged <6 years underwent neurodevelopmental testing and an age-appropriate quality of life assessment.
Results:
The MVS identified mild PTS in 20 children and moderate PTS in 1 child (including 14 of 33 [42%] in the CHD/DVT group, 5 of 37 [14%] in the CHD/no DVT group, and 2 of 30 controls [7%]). The diagnosis of PTS was confirmed clinically in 14 patients, all of whom had previous thrombosis and 1 of whom was MVS-negative. MVS had an accuracy of 91% and performed reasonably well as a screening tool but poorly as a diagnostic tool. MVS reliability was acceptable. Children with PTS had similar quality of life as those without PTS but had higher rates of neurodevelopmental delays in gross motor skills (70% vs 24%; P = .02) and problem-solving indicators (60% vs 15%; P = .008).
Conclusions:
Using the MVS scale for PTS screening in children with CHD is feasible and reliable, and the scale has good correlation with a clinical diagnosis of PTS despite a high prevalence of false-positive findings. Further research is needed to determine the clinical relevance of PTS in this population.
Related Concept Videos
01:29Drug Dosing: Infants and Children
01:24Nephrotic Syndrome I : Introduction
01:30Acute Coronary Syndrome I: Introduction
01:22Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
01:17Irritable Bowel Syndrome I: Introduction
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
01:19Cardiac Output I:Effect of Heart Rate on Cardiac Output
Cardiac output (CO) refers to the total amount of blood ejected by one of the ventricles in liters per minute (L/min). In a resting adult, CO ranges from 5 to 6 L/min, adjusting according to the body's metabolic requirements.
Effect of Heart Rate on Cardiac Output
Cardiac output adapts to metabolic demands during stress, physical activity, or illness. The autonomic nervous system regulates heart rate via the sinoatrial node. The parasympathetic nervous system decreases heart...