By David J. Driscoll MD
In accordance with Dr. Driscoll's thirty years of profitable bedside instructing on the Mayo medical institution, basics of Pediatric Cardiology is the proper textbook for citizens in pediatrics, relations drugs, inner drugs, and pediatric and grownup cardiology. This concise, well-organized, and easy-to-understand textual content will be learn cover-to-cover in the course of a pediatric cardiology rotation and focuses sharply on what basic care physicians want to know for preliminary assessment and administration of patients.
Dr. Driscoll explains the various sorts of congenital center defects, targeting the main widespread cardiac difficulties in babies, young children, and youth. Emphasis is on use of latest diagnostic instruments at the side of the actual exam.
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Extra resources for Fundamentals of Pediatric Cardiology
1979;64:579â 583. Freed M, Rocchini A, Rosenthal A, et al. Exercise-induced hypertension after surgical repair of coarctation of the aorta. Am J Cardiol. 1979;43:253â 258. Godfrey S. Exercise testing in children. London: WB Saunders; 1974. James F, Kaplan S, Glueck C, et al. Responses of normal children and young adults to controlled bicycle exercise. Circulation. 1980;61:902â 912. Jones N, Cambell E. Clinical exercise testing, 2nd ed. Philadelphia, PA: WB Saunders; 1982. MacDougall J, Tuxon D, Sale D, et al.
After complete repair, exercise tolerance does not show much change compared to that after first-stage repair, but hypoxemia is essentially eliminated when the ventilatory response to exercise normalizes. Single Ventricle The cardiorespiratory response to exercise in patients with unrepaired forms of functional single ventricle is typical for cyanotic forms of congenital heart disease. Maximum aerobic power is reduced, the rest hypoxemia is more marked with exercise, and ventilation is excessive relative to [V with dot above]O2.
It is best heard at the base of the neck or in the infra- or supraclavicular areas. It is more prominent on the right than the left side and is dependent on head and neck position. A change in the position of the patient's head can bring out or eradicate a venous hum. Digital compression of the jugular venous system also will obliterate the murmur. A venous hum disappears in the supine position because the influence of gravity on blood flow from the head to the heart is altered; presumably, the speed of flow, and hence turbulence, is reduced.