Clinical spectrum of previously undiagnosed pediatric cardiac disease
Jay D Fisher1, Robert J Bechtel1, Korrina N Siddiqui1
1UNLV School of Medicine, Department of Emergency Medicine, United States of America.
Insights
Previously undiagnosed pediatric cardiac disease presents a diagnostic challenge in emergency departments. Early recognition and intervention are crucial for this high-risk group, despite infrequent individual occurrences.
Area of Science:
- Pediatric Cardiology
- Emergency Medicine
- Diagnostic Challenges
Background:
- Previously undiagnosed pediatric cardiac disease poses a significant challenge for emergency physicians.
- Symptoms can mimic other common pediatric conditions, delaying diagnosis and treatment.
- A high index of suspicion and clinical expertise are vital for timely management.
Purpose of the Study:
- To identify the incidence and characteristics of previously undiagnosed cardiac disease in pediatric emergency department presentations.
- To highlight the clinical spectrum and outcomes of these emergent cardiac conditions.
Main Methods:
- A retrospective chart review was conducted over a five-and-a-half-year period.
- Explicit criteria and structured data collection were used to identify eligible patients.
- All children presenting with previously undiagnosed cardiac disease were included.
Main Results:
- Thirty-six cases were identified, representing 1 in 4838 pediatric emergency department presentations.
- A wide range of chief complaints, presentations, and diagnoses were observed, including congenital and acquired heart disease, arrhythmias, and infections.
- Significant rates of surgical intervention (22%) and mortality (6%) were noted.
Conclusions:
- Previously undiagnosed cardiac conditions represent a high-risk subset of pediatric emergency department patients.
- These conditions occur infrequently individually, challenging pattern recognition for clinicians.
- Prompt diagnosis and intervention are critical for improving outcomes in this population.
Abstract:
Previously undiagnosed pediatric cardiac disease represents a clinical challenge for the emergency physician. The clinical presentation of these disorders can mimic other conditions of the respiratory, gastrointestinal and neurologic systems at a time when the need for early identification and treatment is at a premium. A high index of suspicion and superb clinical acumen is required to make a timely diagnosis and initiate optimal care.
Methods:
A retrospective chart review using explicit criteria and a structured data collection process was performed on all children presenting with previously undiagnosed cardiac disease over a five and half year period.
Results:
Thirty-six patients were identified over a five and a half year period representing one patient per 4838 pediatric ED presentations. A diverse set of chief complaints, triage categories, clinical presentations and diagnoses were identified. Undiagnosed congenital lesions, acquired cardiac disease, dysrhythmias and infectious diseases of the heart were represented. The need for surgical intervention (22%) and mortality (6%) was substantial.
Conclusion:
In the aggregate, these conditions occur at an important rate and represent a high risk subset of pediatric patients presenting to the emergency department. Individually, the conditions occur infrequently and 'pattern recognition' may not aid the clinician. Early diagnosis and prompt intervention is important in this population.
Related Concept Videos
02:37The Electromagnetic Spectrum
01:24The Electromagnetic Spectrum
01:24Chronic Kidney Disease II: Clinical Manifestations
01:19IR Spectrum
Transmittance is defined as the ratio of the radiant power passing through a sample to that from the radiation's source. Multiplying the transmittance by 100 gives the percent transmittance (%T), which varies between 100% (no absorption) and 0%...
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
01:30Coronary Artery Disease III: Clinical Manifestations