Pediatric Cardiology

Biography

Biography: Christopher Snyder

Abstract

The purpose of this talk is to define pediatric palpitations and discuss their evaluation and treatment ranging from the simple ECG to the implantable defibrillator. Palpitations are defined as a rapid pulsation or throbbing of the heart resulting in irregular, fast or abnormal heart beats. Palpitations are common in pediatrics and generally benign in nature. The evaluation of the pediatric patients with palpitations is guided by the history, physical examination and events that surround the episodes. Often times, the etiology of the palpitation can be discerned through a complete history of the events and little more is required such is the case in patients with anxiety, syncope and fever. Occasionally, the findings on the history or physical examination dictates the need for simple cardiac testing such as an ECG, Holter, tilt table or event monitor, often used to evaluate for syncope or dysarrhythmia. The primary worry clinician faces when presented with a patient with palpitations is their risk of sudden death. If the patients’ history, family history or physical examination deviates from acceptable, this triggers a more through evaluation to discern the cause of the palpitation. This work up often includes an ECGs and Holter monitor, an exercise stress test, an echocardiograms or cardiac MRI and often leads to further invasive testing either in the catheterization or electrophysiology laboratory. These more invasive tests are often required to rule out causes of sudden cardiac death that present with palpitations such as hypertrophic cardiomyopathy, prolonged QT syndrome and arrhythmogenic right ventricular dysplasia.