Pediatric Cardiology [antikvár]

A Preface Since the advent of pediatric cardiac catheterization, echocardiography, and magnetic resonance imaging, less emphasis has been placed on more traditional methods of evaluating a cardiac patient. Most practitioners, however, either do not have these refined diagnostic techniques available to them or lack the training to apply them. To evaluate a cardiac patient, the practitioner therefore depends either on the combination of results from the physical examination, the electrocardiogram, and the chest x-ray or on the referral of the patient to a cardiac diagnostic center. The purpose of this book is to formulate guidelines by which the practitioner, medical student, or house officer can approach the diagnostic problem presented by an infant or child with a cardiac finding. Through proper assessment and integration of the history, physical examination, electrocardiogram, and chest x-ray, the type of problem can be diagnosed correctly in 80 percent of patients, and the severity and hemodynamics can be accurately estimated. Even though a patient may still require referral to a cardiac center, this book gives the practitioner a better appreciation of the specific type of specialized diagnostic studies performed and a better understanding of the approach, timing, and results of operation and/or management. This book helps practitioners select patients for referral and offers them guidelines for the timing of referrals. The material is divided into 12 chapters as follows: Diagnostic Methods covers history, physical examination, electrocardiography, and chest radiography and discusses functional murmurs. It also includes a brief overview of special procedures, such as echocardiography and cardiac catheterization. Preventive Cardiology and Health Promotion discusses preventive issues for children with normal hearts (the vast majority), including smoking, hypertension, lipids, exercise, and other risk factors for adult-manifest cardiovascular disease. Prevention and health maintenance issues particular to children with heart disease are also discussed. Heart Disease in Special Populations presents syndromes, genetic disorders, and maternal conditions commonly associated with congenital heart disease. The chapters titled Classification and Pathophysiology, Acyanotic Lesions, Obstructive Lesions, Cyanotic Lesions, and Other Congenital Cardiac Anomalies discuss specific congenital cardiac malformations. The hemodynamics of the malformations are presented as a basis for understanding physical findings, the electrocardiogram, and chest radiographs. Emphasis is placed on features that permit differential diagnosis. Cardiac Conditions in the Neonate describes the cardiac malformations leading to symptoms both in the neonatal period and in the transition from the fetal to the adult circulation. 1 1 JviviW'»'. (i