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New pediatric heart failure guidelines a first in Canada
Date:10/29/2012

we face is that our patients are often presenting very late and with advanced disease. The earlier they are diagnosed, the more likely it is that we will be able to offer effective treatment."

The new guidelines will provide a framework for early recognition and treatment.

The key recommendations for early recognition are:

  • Cardiomyopathy, or heart muscle disease, is one of the main causes of heart failure in children and should be excluded when a child presents with unexplained rapid heart rate or rapid breathing. This may be a familial condition caused by one of several gene abnormalities.
  • Myocarditis, a viral infection of the heart muscle, may be present when children present with abdominal pain and vomiting and have signs of poor circulation.
  • Specialized pediatric echocardiography is required to exclude heart failure and should be obtained in children with unexplained symptoms and signs of abnormal circulation.

"Often children are brought to the emergency room with shortness of breath and some cough and are thought to have asthma, when in fact they have very severe heart failure," says Dr. Kantor. "The clues of a very unusually fast heart rate and low blood pressure are sometimes overlooked and these children will be sent home with a 'puffer' for their breathing problems, which are actually due to heart failure."

In the same way, he says, teenagers who come to the emergency room with nausea and vomiting and abdominal pain may be thought to have gastroenteritis but may actually have myocarditis. "This is one of the earlier considerations that people in the emergency department should make, since the earlier this is diagnosed, the better the outcome."

Pediatric echocardiography is a specialty in its own right and is different from adult echocardiography. Unfortunately, echocardiography is sometimes done in a non-expert setting, which can lead to misdiagnosis and delay in starting the co
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Contact: Jane-Diane Fraser
jfraser@hsf.ca
613-569-4361 x273
Heart and Stroke Foundation of Canada
Source:Eurekalert

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