Gastroenterology, Heart, Pediatric Services

Navigating the confluence: Gastrointestinal considerations in pediatric congenital heart disease within the medical home

Myocarditis represents a significant cause of morbidity and mortality in pediatric patients, yet its clinical presentation can be deceptively subtle. As inflammation of the heart muscle and conduction system, myocarditis affects the heart’s ability to contract effectively and maintain normal rhythm, potentially leading to sudden cardiac death even in previously healthy children. Epidemiology and risk…

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Heart, News

When to refer a pediatric syncope patient

Although most pediatric syncope cases are benign, general providers should be able to distinguish red-flag symptoms and refer patients as necessary. “Providers should differentiate syncope from cardiac conditions, seizures, metabolic disturbances or psychogenic causes,” said Delwyn E. McOmber, M.D., pediatric cardiologist with Norton Children’s Heart Institute, affiliated with the UofL School of Medicine. By taking…

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Heart

Pediatric Chest Pain: A Guide for General Healthcare Providers

Chest pain in pediatric patients is a common complaint, yet less than 5% of cases are due to cardiac disease. However, providers always should conduct a broad differential diagnosis and remain aware of red-flag symptoms indicating possible cardiac involvement, referring patients to cardiology for further testing and evaluation as needed. Common causes of pediatric chest…

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Case Study, Heart, Pediatric Services

Leadless pacemaker allows pediatric athlete to continue competing

The patient A 15-year-old female with congenital complete heart block needed a pacemaker battery change or pacemaker update. Congenital complete heart block leads to interruption of electrical signals between the top chambers of the heart and the bottom chambers of the heart. This often causes clinically significant slow heart rates and eventually requires implantation of…

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Heart, Pediatric Services

Norwood vs. COMPSII for critical left heart obstruction with prior palliation

Surgeons face two choices for infants with critical left heart obstruction who have had prior hybrid palliation: a Norwood operation or a comprehensive stage II (COMPSII). The critical left heart obstruction cohort of the multi-institutional Congenital Heart Surgeons’ Society looked at patient characteristics and outcomes for these two pathways. The study, “Norwood Operation Versus Comprehensive…

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Heart, Pediatric Services

Intraoperative electrophysiology mapping allows surgeon to steer clear of invisible conduction tissue

The patient A 4-year-old girl presented with congenital heart disease consisting of partial atrioventricular canal defect. Surgical repair was necessary. The challenge Injury to the cardiac conduction system during cardiac surgery may result in complete heart block in 25% of patients with the most complex congenital heart defects. The injury interrupts the electrical signals transmitted from…

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Heart, Pediatric Services

Norton Children’s collaborates with patients’ providers for high-risk pregnancy care

If a congenital heart condition is expected for a high-risk pregnancy, referring providers still can  retain their patients through delivery by collaborating with Norton Children and Norton Healthcare. We use an integrated approach for collaborative care among obstetrics, maternal-fetal medicine (MFM) and fetal cardiology specialties. Referring providers will remain the primary contact for the patient,…

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Heart, Pediatric Services

Second opinion process for fetal cardiology patients

We know it’s a stressful time for parents when they learn their child will be born with a congenital heart condition, and it is normal for patients to want to seek a second opinion. Other providers may encourage a second opinion, and we welcome patients seeking second opinions at Norton Children’s Heart Institute, affiliated with…

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Anesthesology, Heart, Pediatric Services

Erector spinae plane block and pediatric heart surgery

Using an anesthesia block such as erector spinae plane block in some pediatric cardiac surgeries has allowed us to quicken patient recovery, shorten stays in the cardiac intensive care unit (CICU) and extubate sooner. By blocking the afferent neuronal impulses in surgeries involving a midline sternotomy, erector spinae plane blocks reduce the body’s sensation of…

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Heart, Pediatric Services

At the forefront with hybrid approach for complex congenital heart disease in high-risk neonate

Babies born with complex congenital heart disease often can have associated issues such as extreme prematurity, low birth weight, abnormal genes and significant congenital disorders other than the heart. These associated issues can significantly increase the risk of their heart surgery. An example is a baby who recently received care at Norton Children’s Hospital. He…

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Heart, Pediatric Services

Adam M. Skaff, M.D., joins Norton Children’s Heart Institute

Adam M. Skaff, M.D., has joined Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, as a pediatric cardiologist. Dr. Skaff completed his initial medical training at the West Virginia University School of Medicine. His residency in pediatrics was completed at the University of Virginia. Dr. Skaff completed fellowship training in pediatric cardiology…

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Heart, Pediatric Services

Genetic testing reveals new diagnosis for patient originally presenting with long QT syndrome

This is a condensed version of “One Family’s Clinical Odyssey From Evolving Phenotypic and Genotypic Knowledge of Catecholaminergic Polymorphic Ventricular Tachycardia and Long QT Syndrome,” which is open access and available to read in full here. Life-threatening arrhythmias in apparently healthy individuals can be due to diverse heritable cardiac channelopathies. Ongoing advances revealing the underlying…

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