ABSTRACT
No disponible
Subject(s)
Humans , Child , Adolescent , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/mortality , Sports/physiology , Early Diagnosis , Medical History Taking/methods , Physical Examination/instrumentation , Physical Examination/methods , Physical Examination , Electrocardiography/instrumentation , Electrocardiography/methods , Electrocardiography , Practice Guidelines as Topic/standardsSubject(s)
Cardiovascular Diseases/diagnosis , Mass Screening , Physical Examination , Sports , Adolescent , Child , HumansABSTRACT
En este artículo se recogen las recomendaciones para la prevención de la endocarditis infecciosa (EI), contenidas en las guías elaboradas por la American Heart Association (AHA) y la European Society of Cardiology (ESC) a partir de las cuales, se han consensuado las recomendaciones de la Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas. En los últimos años se ha producido un cambio considerable en las recomendaciones para la prevención de la EI, motivado principalmente por la falta de evidencia sobre la eficacia de la profilaxis antibiótica en su prevención y el riesgo de desarrollo de resistencias a los antibióticos utilizados. El cambio principal consiste en una reducción de las indicaciones de la profilaxis antibiótica, tanto en lo relativo a los pacientes como a los procedimientos considerados de riesgo. Las guías de práctica clínica y las recomendaciones deben asistir a los profesionales de la salud en la toma de decisiones clínicas en su ejercicio diario. No obstante, el juicio último sobre el cuidado de un paciente concreto lo debe tomar el médico responsable
This article sets out the recommendations for the prevention of infective endocarditis (IE), contained in the guidelines developed by the American Heart Association (AHA) and the European Society of Cardiology (ESC), from which the recommendations of the Spanish Society of Paediatric Cardiology and Congenital Heart Disease have been agreed. In recent years, there has been a considerable change in the recommendations for the prevention of IE, mainly due to the lack of evidence on the effectiveness of antibiotic prophylaxis in prevention, and the risk of the development of antibiotic resistance. The main change is a reduction of the indications for antibiotic prophylaxis, both in terms of patients and procedures considered at risk. Clinical practice guidelines and recommendations should assist health professionals in making clinical decisions in their daily practice. However, the ultimate judgment regarding the care of a particular patient must be taken by the physician responsible
Subject(s)
Humans , Male , Female , Child , Endocarditis, Bacterial/prevention & control , Antibiotic Prophylaxis , Heart Defects, Congenital/complications , Practice Patterns, Physicians' , Risk Factors , Viridans Streptococci/pathogenicity , Staphylococcus aureus/pathogenicityABSTRACT
This article sets out the recommendations for the prevention of infective endocarditis (IE), contained in the guidelines developed by the American Heart Association (AHA) and the European Society of Cardiology (ESC), from which the recommendations of the Spanish Society of Paediatric Cardiology and Congenital Heart Disease have been agreed. In recent years, there has been a considerable change in the recommendations for the prevention of IE, mainly due to the lack of evidence on the effectiveness of antibiotic prophylaxis in prevention, and the risk of the development of antibiotic resistance. The main change is a reduction of the indications for antibiotic prophylaxis, both in terms of patients and procedures considered at risk. Clinical practice guidelines and recommendations should assist health professionals in making clinical decisions in their daily practice. However, the ultimate judgment regarding the care of a particular patient must be taken by the physician responsible.
Subject(s)
Endocarditis, Bacterial/prevention & control , Antibiotic Prophylaxis , Child , HumansABSTRACT
Continuamos con la serie de casos clínicos en Cardiología pediátrica, revisando los motivos de consulta y datos exploratorios frecuentes en las consultas de Pediatría de Atención Primaria, y presentados de forma breve y práctica. En este número se presenta el caso de un lactante de tres meses que acude por fatiga y sudoración con las tomas. Se discute cómo la exploración y los hallazgos electrocardiográficos orientan el manejo diagnóstico de este paciente (AU)
We continue the series of clinical cases in Pediatric Cardiology checking frequent reasons for consultation in the pediatric offices of Primary Care as well as exploratory signs, and presenting them in a brief and practical way. In this paper, we present the case of a 3 month-old infant who is taken because of shortness of breath and sweating with feeding. The way the physical exploration and the electrocardiographic findings guide the diagnosis of this patient is discussed (AU)
Subject(s)
Humans , Male , Infant , Fatigue/complications , Fatigue/diagnosis , Fatigue/etiology , Systolic Murmurs/complications , Systolic Murmurs/diagnosis , Systolic Murmurs/etiology , Electrocardiography/methods , Electrocardiography , Echocardiography , Fatigue/physiopathology , Fatigue , Stroke Volume/physiology , Stroke Volume/radiation effects , Systolic Murmurs/physiopathology , Systolic Murmurs , Primary Health Care/methods , Primary Health Care/trendsABSTRACT
Continuamos con la serie de casos clínicos en Cardiología Pediátrica revisando los motivos de consulta frecuentes en las consultas de Pediatría de Atención Primaria, presentados de forma breve y práctica y tratando de mostrar la utilidad del electrocardiograma, método diagnóstico del que disponemos en Atención Primaria. En este número se presenta el caso de un niño de ocho años en el que se detecta un soplo cardiaco en una revisión rutinaria. Se discute cómo la exploración y los hallazgos electrocardiográficos orientan el manejo de este paciente (AU)
We continue the series in Paediatric Cardiology checking frequent reasons for consultation in the paediatric offices of Primary Care, presenting them in a brief and practical way and trying to show the electrocardiogram usefulness, diagnostic tool available at the Primary Care office. In this paper we present the case of an 8 years old boy with a systolic cardiac murmur detected in the well child consultation. The way clinical and electrocardiographic findings guide the diagnosis of this patient is discussed (AU)
Subject(s)
Humans , Male , Child , Systolic Murmurs/complications , Systolic Murmurs/diagnosis , Cardiovascular Diseases/complications , Cardiovascular Diseases/prevention & control , Systolic Murmurs , Electromyography/methods , Electromyography/trends , Electromyography , Primary Health Care/methods , Primary Health Care , Cardiovascular Diseases , Heart Rate/physiologyABSTRACT
El dolor torácico, un motivo de consulta poco frecuente en pediatría, es causante de una gran preocupación tanto en el paciente como en su familia, al ser percibido como una patología cardiaca potencialmente letal. Si bien en la mayoría de los casos se trata de un proceso benigno, también puede ser reflejo de una enfermedad grave. Exponemos los casos de 6 niños que consultaron en el servicio de urgencias por precordalgia, y que fueron diagnosticados de hernia diafragmática postraumática, neumotórax espontáneo, rabdomiosarcoma, linfoma no hodgkiniano, ganglioneuroma y síndrome de Wolff-Parkinson-White(AU)
Chest pain constitutes a rare case in pediatrics and is a worrisome symptom for both patients and their families, who often fear a potentially lethal cardiac disease. Although in most cases it is a benign process, it can also be secondary to an underlying serious disease. We present 6 children who consulted in the Emergency Department because of chest pain, whose outright diagnoses were: post-traumatic diaphragmatic hernia, spontaneous pneumothorax, rhabdomyosarcoma, non-Hodgkin´s lymphoma, ganglioneuroma and Wolff-Parkinson-White syndrome(AU)
Subject(s)
Humans , Male , Female , Child , Chest Pain/etiology , Diagnosis, Differential , Wolff-Parkinson-White Syndrome/diagnosis , Pneumothorax/diagnosis , Hernia, Diaphragmatic/diagnosis , Lymphoma, Non-Hodgkin/diagnosisABSTRACT
Continuamos con la serie de casos clínicos en Cardiología pediátrica, revisando los motivos de consulta frecuentes en las consultas de Pediatría de Atención Primaria, presentados de forma breve y práctica y tratando de mostrar la utilidad del electrocardiograma, método diagnóstico del que disponemos en Atención Primaria. En este número se presenta el caso de un adolescente de 14 años que se queja de dolor torácico. Se discute cómo las características del dolor y los hallazgos electrocardiográficos orientan el manejo de este paciente (AU)
We continue the series in Paediatric Cardiology checking frequent reasons for consultation in the paediatric offices of Primary Care, presenting them in a brief and practical way and trying to show the electrocardiogram usefulness, diagnostic tool available at the Primary Care office. In this paper we present the case of a 14 years old adolescent who complains of chest pain. The way clinical and electrocardiographic findings guide the diagnosis of this patient is discussed (AU)
Subject(s)
Humans , Female , Adolescent , Primary Health Care/methods , Primary Health Care/trends , Cardiomyopathies , Chest Pain/etiology , Chest Pain , Electrocardiography/methods , Cardiomyopathies/epidemiology , Electrocardiography/trends , ElectrocardiographyABSTRACT
Continuamos con la serie de casos clínicos en Cardiología Pediátrica revisando los motivos de consulta frecuentes en las consultas de Pediatría de Atención Primaria, presentados de forma breve y práctica y tratando de mostrar la utilidad del electrocardiograma, método diagnóstico del que disponemos en Atención Primaria. En este número se presenta el caso de una niña de 11 años con un soplo cardiaco detectado en una revisión del niño sano. Se discute cómo las características del soplo y los hallazgos electrocardiográficos orientan el manejo de esta paciente (AU)
We continue the series of clinical cases in Paediatric Cardiology checking frequent reasons for consultation in the paediatric offices of Primary Care, presenting them in a brief and practical way and trying to show the electrocardiogram usefulness, diagnostic tool available at the primary care office. In this paper we present the case of an 11 years old girl with a heart murmur found in a well child examination exam. The way clinical and electrocardiography findings guide the diagnosis of this patient is discussed (AU)
Subject(s)
Humans , Female , Child , Heart Murmurs , Primary Health Care/methods , Primary Health Care/trends , Arrhythmias, Cardiac/complications , Arrhythmias, Cardiac/diagnosis , Heart Murmurs/complications , Heart Murmurs/physiopathology , Electrocardiography/methods , Electrocardiography/trends , Arrhythmias, CardiacABSTRACT
No disponible
Subject(s)
Humans , Pediatrics/education , Education, Medical/trends , Specialization/trends , Educational Measurement , CurriculumABSTRACT
Introducción y objetivos: En el postoperatorio de la cirugía cardíaca se produce una respuesta inflamatoria sistémica que dificulta la identificación de complicaciones. El objetivo fue estudiar el comportamiento de la proteína C reactiva (PCR) y la procalcitonina (PCT), valorando su relación con la gravedad y analizando su utilidad para detectar complicaciones. Métodos: Se estudió prospectivamente a 59 niños intervenidos mediante cirugía cardíaca abierta. Se determinaron la PCR y la PCT al ingreso en una unidad de cuidados intensivos pediátricos, a las 24, a las 48 y a las 72h. Se analizó la relación de la PCR y la PCT con la gravedad clínica valorada mediante las escalas Pediatric Risk Mortality y Therapeutic Intervention Scoring System, y el desarrollo de complicaciones (infecciosas y hemodinámicas). Resultados: La PCR y la PCT aumentaron en las primeras 24h, disminuyendo progresivamente en los 2 días posteriores. La PCR no se relacionó con la gravedad ni con la aparición de complicaciones. La PCT tras la cirugía, a las 24 y a las 48h presentó una moderada correlación con el Pediatric Risk Mortality (r=0,548; 0,434 y 0,446, respectivamente) y una baja con el Therapeutic Intervention Scoring System. Se obtuvieron unos puntos de corte para la PCT>0,17ng/ml (sensibilidad del 73,3%, especificidad del 72,2%) al ingreso y >1,98ng/ml (sensibilidad del 57,1%, especificidad del 87%) a las 48h para detectar complicaciones. No existieron diferencias en la PCR ni en la PCT entre los pacientes con complicaciones infecciosas y hemodinámicas. Conclusiones: En el postoperatorio de la cirugía cardíaca pediátrica la PCR no se correlaciona con la gravedad ni con la presencia de complicaciones. La PCT se correlaciona con la gravedad y puede detectar complicaciones posquirúrgicas (AU)
Introduction and objectives: The systemic inflammatory response syndrome developed after cardiac surgery impedes the detection of complications. The aim of our study was to examine the behaviour of C-reactive protein (CRP) and procalcitonin (PCT), as well as to evaluate its relationship with severity and to analyse its usefulness in the identification of complications. Methods: A total of 59 children who underwent cardiac surgery with cardiopulmonary bypass were prospectively studied. CRP and PCT were determined after surgery and at 24, 48 and 72 hours. The relationships between both parameters and the clinical severity were analysed (evaluated with PRISM and TISS scoring systems), as well as with the incidence of complications (infectious and haemodynamics). Results: Serum concentrations of CRP and PCT increased in the first 24 hours after surgery, with a gradual decrease over the following days. There was no association between CRP and severity or development of complications. A moderate correlation was observed between PCT after surgery, at 24 and 48 hours, and PRISM (r=0.548; 0.434 and 0.446) and a low correlation between PCT and TISS. When studying the identification of complications, we obtained cut-off values of PCT>0.17ng/ml (Ss 73.3%; Sp 72.2%) and PCT>1.98ng/ml (Ss 57.1%; Sp 87%) immediately and 48 hours after surgery. No differences were found in CPR and PCT levels among patients with infectious and haemodynamics complications. Conclusions: CPR does not correlate with the severity or the incidence of complications after paediatric cardiac surgery. PCT correlates with clinical severity and may be able to detect post-surgical complications (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , C-Reactive Protein/biosynthesis , C-Reactive Protein , C-Reactive Protein/metabolism , Thoracic Surgery/classification , Thoracic Surgery/instrumentation , Thoracic Surgery/methods , Calcitonin/biosynthesis , Calcitonin/metabolism , Shock, Cardiogenic/complications , Shock, Cardiogenic/diagnosis , Shock, Cardiogenic/pathologyABSTRACT
Continuamos con la serie de casos clínicos en Cardiología Pediátrica revisando los motivos de consulta y los datos exploratorios en las consultas de Pediatría de Atención Primaria, presentados de forma breve y práctica. En este número se recoge el caso de un niño de diez años que consulta por dolor abdominal, detectando en la exploración física general una auscultación cardiaca arrítmica. Se discute la interpretación del electrocardiograma y el manejo del paciente(AU)
Subject(s)
Humans , Male , Child , Heart Auscultation/methods , Heart Auscultation/trends , Primary Health Care/methods , Primary Health Care/trends , Electrocardiography/statistics & numerical data , Electrocardiography , Arrhythmias, Cardiac/epidemiology , Cardiac Complexes, Premature/diagnosis , Cardiac Complexes, PrematureABSTRACT
INTRODUCTION AND OBJECTIVES: The systemic inflammatory response syndrome developed after cardiac surgery impedes the detection of complications. The aim of our study was to examine the behaviour of C-reactive protein (CRP) and procalcitonin (PCT), as well as to evaluate its relationship with severity and to analyse its usefulness in the identification of complications. METHODS: A total of 59 children who underwent cardiac surgery with cardiopulmonary bypass were prospectively studied. CRP and PCT were determined after surgery and at 24, 48 and 72 hours. The relationships between both parameters and the clinical severity were analysed (evaluated with PRISM and TISS scoring systems), as well as with the incidence of complications (infectious and haemodynamics). RESULTS: Serum concentrations of CRP and PCT increased in the first 24 hours after surgery, with a gradual decrease over the following days. There was no association between CRP and severity or development of complications. A moderate correlation was observed between PCT after surgery, at 24 and 48 hours, and PRISM (r=0.548; 0.434 and 0.446) and a low correlation between PCT and TISS. When studying the identification of complications, we obtained cut-off values of PCT>0.17ng/ml (Ss 73.3%; Sp 72.2%) and PCT>1.98ng/ml (Ss 57.1%; Sp 87%) immediately and 48 hours after surgery. No differences were found in CPR and PCT levels among patients with infectious and haemodynamics complications. CONCLUSIONS: CPR does not correlate with the severity or the incidence of complications after paediatric cardiac surgery. PCT correlates with clinical severity and may be able to detect post-surgical complications.
Subject(s)
C-Reactive Protein/analysis , Calcitonin/blood , Cardiac Surgical Procedures , Protein Precursors/blood , Calcitonin Gene-Related Peptide , Humans , Infant , Postoperative Complications/blood , Prospective StudiesABSTRACT
Continuamos con la serie de casos clínicos en cardiología pediátrica revisando los motivos de consulta y los datos exploratorios en las consultas de Pediatría de Atención Primaria, presentados de forma breve y práctica. En este número se recoge el caso de un niño de 12 años al que se le detecta una auscultación cardíaca anómala en el contexto de una gastroenteritis aguda. Se discute cómo la exploración y los hallazgos electrocardiográficos orientan el manejo diagnóstico de este paciente (AU)
We continue the series of clinical cases in Pediatric Cardiology checking reasons for consultation in the pediatric offices of Primary Care as well as exploratory signs, and presenting them in a brief and practical way. In this paper we present the case of a 12 years old boy to whom an anomalous cardiac auscultation is noticed in the context of an acute gastroenteritis. The way the physical exploration and the electrocardiographic findings guide the diagnosis of this patient is discussed (AU)
Subject(s)
Humans , Male , Child , Gastroenteritis/complications , Heart Defects, Congenital/diagnosis , Situs Inversus/diagnosis , Heart Auscultation , Incidental FindingsABSTRACT
El dolor torácico es un motivo de consulta relativamente poco frecuente en niños y adolescentes. No obstante, genera gran ansiedad y preocupación al niño y a su familia, pues es percibido con frecuencia como una patología cardíaca potencialmente letal. Presentamos una revisión del tema, incidiendo sobre el diagnóstico y el manejo inicial de estos pacientes (AU)
Chest pain is a relatively uncommon reason for consultation during childhood and adolescence. Nevertheless, it may be alarming for the patient and family, due to the fact that it is usually misinterpreted as a potentially lethal cardiac disease. We present a review about this topic, focusing on diagnosis and initial management of these patients (AU)
Subject(s)
Humans , Heart Diseases/epidemiology , Chest Pain/etiology , Diagnosis, Differential , Risk Factors , Physical Examination/methodsABSTRACT
Continuamos con la serie de casos clínicos en cardiología pediátrica revisando los motivosde consulta y los datos exploratorios frecuentes en las consultas de Pediatría de AtenciónPrimaria, presentados de forma breve y práctica. En este número se cuenta el caso deun niño de 14 años que refiere tener palpitaciones de inicio repentino. Se discute cómo laexploración y los hallazgos electrocardiográficos orientan el manejo diagnóstico de este paciente(AU)
We continue the series of clinical cases in Paediatric Cardiology reviewing common reasonsfor consultation in the paediatric Primary Care offices, presented in a brief and practicalway. In this paper we present the case of a 14 year old boy with sudden onset palpitations.The way physical exam and electrocardiographic findings guide the diagnosis in this patientis discussed(AU)
Subject(s)
Humans , Male , Adolescent , Tachycardia, Supraventricular/complications , Tachycardia, Supraventricular/diagnosis , Wolff-Parkinson-White Syndrome/complications , Wolff-Parkinson-White Syndrome/diagnosis , Primary Health Care/methods , Tachycardia, Supraventricular/therapy , Tachycardia, Supraventricular , Wolff-Parkinson-White Syndrome/etiology , Wolff-Parkinson-White Syndrome/physiopathologyABSTRACT
Introducción: Se ha descrito una elevada prevalencia de anticuerpos anticélula parietal gástrica (ACPG) en niños con enfermedad tiroidea autoinmunitaria (ETAI). El objetivo de este trabajo fue determinar la prevalencia de marcadores de gastritis autoinmunitaria en niños con ETAI. Sujetos y métodos: Se incluyó a 26 pacientes con ETAI. Se realizaron hemograma, valores plasmáticos de vitamina B12, ácido fólico, gastrina y ACPG. Se estudió también la comorbilidad de otras enfermedades autoinmunitarias. Resultados: Los valores de tiroxina libre y tirotropina fueron normales con tratamiento hormonal sustitutivo. Los valores de hemoglobina, volumen corpuscular medio, hemoglobina corpuscular media, vitamina B12, ácido fólico y gastrina estaban en rango de normalidad en todos los niños. Se detectaron 6 casos de diabetes mellitus de tipo 1 (DM1) y 2 de ellos también tenían enfermedad celíaca (EC). Se halló ACPG en una niña hipertiroidea de 14 años sin comorbilidad autoinmune. Conclusiones: La ETAI se asocia a otras enfermedades de similar etiología, principalmente DM1 y EC. La presencia de ACPG es un marcador precoz y sensible de gastritis autoinmunitaria (AU)
Introduction: A high prevalence of parietal cell antibodies (PCA) has been reported in children with autoimmune thyroid disease (AITD). The aim of this study was to determine the prevalence of autoimmune gastritis markers among children diagnosed as AITD. Patients and methods: We studied 26 patients with AITD. Basal samples were taken to determine: hemogram, vitamin B12 and folic acid plasmatic levels, gastrin plasmatic levels, and PCAs determination. Other autoimmune disease comorbility were also studied. Results: Free T4 and TSH values were normal, with hormonal substitutive treatment. Hb, MCV, HCM, vitamine B12, folic acid and gastrin were in normal range for all 26 patients. We reported 6 cases diabetes mellitus type 1 and 2 of celiac disease. A single patient was PCA positive. It was a 14-year-old hyperthyroid girl without any other autoimmune disease. Conclusions: AITD in childhood and adolescence is associated with other autoimmune diseases, specially DM1 and CD. PCA becomes an early and sensitive marker to detect autoinmune gastritis (AU)
Subject(s)
Humans , Male , Female , Child , Thyroiditis, Autoimmune/complications , Gastritis, Atrophic/complications , Gastritis/immunology , Autoimmune Diseases/diagnosis , Parietal Cells, Gastric/immunology , Gastrins/analysis , Prospective Studies , Graves Disease/immunology , Thyroid Function TestsABSTRACT
INTRODUCTION: A high prevalence of parietal cell antibodies (PCA) has been reported in children with autoimmune thyroid disease (AITD). The aim of this study was to determine the prevalence of autoimmune gastritis markers among children diagnosed as AITD. PATIENTS AND METHODS: We studied 26 patients with AITD. Basal samples were taken to determine: hemogram, vitamin B12 and folic acid plasmatic levels, gastrin plasmatic levels, and PCA's determination. Other autoimmune disease comorbidity were also studied. RESULTS: Free T4 and TSH values were normal, with hormonal substitutive treatment. Hb, MCV, HCM, vitamin B12, folic acid and gastrin were in normal range for all 26 patients. We reported 6 cases diabetes mellitus type 1 and 2 of celiac disease. A single patient was PCA positive. It was a 14-year-old hyperthyroid girl without any other autoimmune disease. CONCLUSIONS: AITD in childhood and adolescence is associated with other autoimmune diseases, specially DM1 and CD. PCA becomes an early and sensitive marker to detect autoimmune gastritis.
Subject(s)
Autoimmune Diseases/complications , Gastritis/complications , Gastritis/immunology , Thyroid Diseases/complications , Thyroid Diseases/immunology , Adolescent , Autoimmune Diseases/epidemiology , Child , Cross-Sectional Studies , Female , Gastritis/epidemiology , Humans , Male , Prevalence , Prospective Studies , Young AdultABSTRACT
La miocardiopatía dilatada es una entidad poco común en pediatría y se clasifica como idiopática en aproximadamente 2 de cada 3 casos. Las anomalías coronarias son una causa excepcional de esta enfermedad, si bien deben formar parte del diagnóstico diferencial, especialmente ante signos electrocardiográficos sugerentes de isquemia o infarto de miocardio, pues un tratamiento quirúrgico precoz revierte la dilatación ventricular y normaliza la función miocárdica. Presentamos el caso de una lactante con síndrome de Bland-White-Garland, que es la anomalía coronaria congénita más frecuente (AU)
Dilated cardiomyopathy is a rare disease in paediatrics, and approximately two out of each three cases remain labelled as idiopathic. The coronary abnormalities are a very uncommon cause of the before mentioned, even though it has to be considered as part of the differential diagnosis and specially when myocardial ischemic or infarction electrocardiographic signs coexist, since with an early surgical procedure it may lead to normalization of ventricular dimensions and myocardial function. We report the case of an infant diagnosed with the Bland-White-Garland syndrome, the most frequent coronary congenital anomaly (AU)
