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Cardiac Emergencies in Kids

Ashley M Strobel1, Leen Alblaihed2

  • 1Department of Emergency Medicine, University of Minnesota Medical School, Hennepin County Medical Center, University of Minnesota Masonic Children's Hospital, 701 South Park Avenue R2.123, Minneapolis, MN 55414, USA.

Emergency Medicine Clinics of North America
|July 3, 2021
PubMed

Insights

Emergency care for children with single-ventricle or ventricular assist device heart conditions can be challenging. This guide helps emergency departments recognize and stabilize common complications in these complex pediatric congenital heart disease patients.

Area of Science:

  • Pediatric Cardiology
  • Emergency Medicine
  • Congenital Heart Disease Surgery

Background:

  • Children with congenital heart disease (CHD) undergoing surgical palliation, particularly those with single-ventricle physiology or ventricular assist devices (VADs), present unique challenges in the emergency department (ED).
  • A lack of familiarity with these complex surgical repairs can induce anxiety and lead to suboptimal care for critically ill pediatric patients.
  • Prompt recognition and management of emergent conditions are vital for improving survival rates in this vulnerable population.

Purpose of the Study:

  • To provide emergency department clinicians with essential knowledge regarding common conditions and complications seen in palliated single-ventricle and VAD patients.
  • To outline effective stabilization strategies for these pediatric CHD patients in an acute care setting.
  • To reduce anxiety and improve confidence among healthcare providers managing these complex cases.

Main Methods:

  • This article reviews common presentations and critical care principles for pediatric patients with single-ventricle physiology or VADs in the ED.
  • It synthesizes current guidelines and expert consensus on the initial management of emergent complications.
  • The focus is on practical, actionable information for immediate bedside application.

Main Results:

  • Key conditions requiring ED evaluation include cardiac decompensation, device malfunction, and systemic illness.
  • Effective stabilization involves rapid assessment, hemodynamic support, and appropriate diagnostic workup tailored to the specific surgical history.
  • Early consultation with pediatric cardiac specialists is often crucial.

Conclusions:

  • Familiarity with common complications and stabilization techniques for surgically palliated CHD patients is essential for ED providers.
  • Implementing standardized approaches can improve patient outcomes and reduce provider anxiety.
  • This knowledge is critical for enhancing the survival chances of children with single-ventricle or VADs presenting to the emergency department.

Keywords:
CardiacCardiogenic shockCongenital cardiac diseasePediatricsResuscitationSingle VentricleStaged palliationVentricular assist device

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