February is American Heart Month — Cyrus’ story

Just in time for American Heart Month, learn about our courageous patient, Cyrus, who underwent complex open heart surgery. His successful journey was met by much celebration from his family and his team of CHOC experts.

Hypoplastic Left Heart Syndrome (HLHS) is a rare congenital heart defect, which is 100 percent fatal if left untreated. Sunny and Jereme Brixey knew about their baby’s risks even before Cyrus was born in 2008, having been prenatally diagnosed.

Prior to Cyrus’ birth, the cardiac team at CHOC Children’s already had a plan of action: an approach involving three different open heart surgeries. Three days after he was born, Cyrus underwent complex open heart surgery. He had a second heart surgery at 4 months and a third at 4 years.

After the third procedure in 2013, Cyrus took a long time to recover in the hospital. After being in the hospital for nearly two months due to persistent drainage from a chest tube, Cardiovascular Intensive Care Unit (CVICU) physician Dr. Michele Domico suggested that Cyrus could be discharged home with a portable chest drain. He would be the first patient in the hospital’s history to be sent home with this device. The cardiologists and surgeons agreed and ordered the new portable chest drain for Cyrus, allowing him to go home.

Cyrus, with Dr. Michele Domico, medical director of CHOC Children's CVICU and Choco, at a CHOC Night at Angels Stadium event.
Cyrus, with Dr. Michele Domico, medical director of CHOC Children’s CVICU and Choco, at a CHOC Night at Angels Stadium event.

At home, Cyrus’ parents took care of him and his chest drain so that he could heal, and the drain was able to be removed after a few weeks. This successful procedure was met by a large cheer from Cyrus’ entire CHOC team. For Sunny and Jereme, this expression of joy reflected the care Cyrus received every step of his journey. In addition to the clinical excellence of the medical team, the Brixeys believe the team’s positive, encouraging words, as well as the support extended to the entire family, were a huge factor in his recovery. Since then, the CVICU team has used the portable chest drain in several other patients with great success.

Learn more about the CHOC Children’s Heart Institute.

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Preventing Sudden Cardiac Arrest in Children

Sudden_Cardiac_Arrest_CHOCSudden cardiac arrest, simply put, describes when a per
son’s heart suddenly stops beating and blood stops flowing to the brain and other vital organs. If the person isn’t treated within minutes, death results, a CHOC Children’s cardiologist says

Sudden cardiac arrest is usually caused by an irregular heartbeat, or a condition called arrhythmia, says Dr. Anjan Batra, medical director electrophysiology at CHOC.

During an arrhythmia, the heart can beat too fast, too slow or with an irregular rhythm. Depending on the type of arrhythmia, it can be relatively harmless, serious or life-threatening.

Many of these conditions can be treated and managed, he says.

“The message I would send to parents is to not be scared, but to be proactive,” he says. “There are often things we can do about it.”

Dr. Batra encourages families of young athletes or any young person with a family history of heart problems to contact their pediatrician, who can refer the child to a pediatric heart specialist for screening if necessary.

Families also should take their child to a doctor or the emergency department for care if the child shows symptoms of heart distress, like fainting, a racing heart or chest pains.

There are several causes of sudden cardiac death in young people, says Dr. Batra.

First, hypertrophic cardiomyopathy (HCM) is a hereditary disease in which the heart muscle becomes abnormally thick, making it harder for the heart to pump blood. While usually not fatal in most people, this condition is the leading cause of sudden cardiac death in young athletes in United States. HCM often is previously undetected, he says.

Second, long QT syndrome is another inherited heart rhythm disorder that can cause fast, chaotic heartbeats. The rapid heartbeats may lead to fainting, and can be life-threatening, Dr. Batra says.

Finally, supraventricular tachycardia (SVT) is common and worrisome. In these cases, a person suddenly feels his heart racing or beating very fast, Dr. Batra says.

“The good news is it’s a condition that is very easily treatable with a non-surgical, outpatient procedure called ablation,” he says. “We have a close to 100 percent cure rate. Families should seek care from someone who specializes in arrhythmias.”

Learn more about the CHOC Children’s Heart Institute.

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The Importance of Heart Screenings for Athletes

Parents of young athletes should talk to their pediatrician about getting pre-participation sports physicals that include heart  screenings.

After all, sudden cardiac death is 2 ½ times more likely to occur in young athletes than in non-athletes. Hypertrophic cardiomyopathy, the most common cause of sudden cardiac death in young athletes, occurs in one of every 500 people.

Young athletes are encouraged to have a physical that includes a general exam, a complete health history and family history, a 12-lead EKG screening and, for athletes with an abnormal EKG or family history, an echocardiogram. An exercise test may also be recommended.

To address the growing rate of sudden cardiac arrest in young athletes, CHOC Children’s Sports Medicine collaborates with the CHOC Children’s Heart Institute to offer the Life-Threatening Events Associated with Pediatric Sports (LEAPS) program. CHOC cardiologists work one-on-one with area schools on several fronts:

• Educate coaches and staff about heart conditions.
• Offer electrocardiogram (EKG) screenings to identify athletes at risk.
• Encourage CPR training and the installation of automatic external defibrillators (AEDs) near gyms, fields and other sports facilities.

CHOC also hosts a regular conference for Orange County school board members, high school coaches, school nurses, community pediatricians and parents who want to lower the incidence of sudden cardiac death in local teenage athletes.

To learn more, contact the CHOC Children’s Heart Institute at 714-532-7576.

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Cardiology: Then and Now

20130424_1668February is national heart month, so I thought there was no better time than now to visit my friends at CHOC Children’s Heart Institute.

So much has changed in the field of pediatric cardiology since I first visited CHOC in 1964. From diagnosis to treatment, the Institute today cares for children of all ages with a spectrum of cardiac conditions. The Institute offers a host of services, ranging from surgery to cardiac catheterization to interventional cardiology.

The Institute also offers expert diagnostics for diagnosing complicated heart issues – the first step in helping a child feel better. Here’s just a snapshot of CHOC’s many diagnostic offerings:

  • Electrocardiogram (EKG), Holter monitoring and cardiac event monitor recording
  • Pediatric ergometer and treadmill stress-testing
  • Fetal echocardiography and prenatal cardiac diagnosis
  • 2D and 3D real-time resting, stress and sedated echocardiography
  • 1.5T and 3.0T magnetic resonance (MRI) and CT angiography with 3-D image reconstruction
  • Diagnostic cardiac catheterization and therapeutic cardiac catheterization in state-of-the-art catheterization laboratories

I love CHOC heart patients, and I’m so grateful for the cardiologists, nurses and other staff who help care for them. How has CHOC helped your heart — besides filling it with joy? Let me know on social media by using the hashtag #thxCHOC.


The CHOC Children’s Heart Institute offers state-of-the-art diagnosis and treatment for an entire spectrum of cardiac conditions all in one convenient, family friendly location. Moreover, it is the only pediatric-dedicated facility in Southern California offering the latest in advanced cardiac care, and is the only regional facility to perform neonatal and pediatric open heart surgery. CHOC has assembled a multi-disciplinary team, specially trained in the management of infants and children with congenital heart defects.


A Healthy Heart Starts Early

Did you know the seeds for a healthy heart in adulthood are often planted during childhood? Children with poor diets and inadequate exercise can develop a range of heart-related diseases later in life.

Parents and other caregivers can set children on a path to a healthy heart, says Dr. Linda Muhonen, a pediatric cardiologist at CHOC Ch20130426_0625ildren’s who also leads CHOC’s Lipid Clinic. (“Lipid” is a general term for molecules in the body that include fat.) Often, this means a permanent lifestyle change for families.

“For kids to have a healthy heart during their lives, families have to lead more healthy lifestyles from the start,” Dr. Muhonen says. Parents should model heart-healthy habits to their children. Prevention is the best way to avoid heart problems later in life.”

Dr. Muhonen and the Lipid Clinic staff help children with genetic dyslipidemias or who are overweight or obese lower their risk for developing heart disease and related illnesses such as asthma or diabetes. They study the patient’s history, examine the child, prescribe medication if necessary and set up new dietary and exercise goals for kids and families with the help of a dietitian and exercise physiologist , she says.

“The bottom line is that our kids are developing diabetes in early adolescence,” Dr. Muhonen says. “Kids can also develop asthma, hypertension and fat in the liver, which can lead to chronic liver disease all related to obesity. You can help prevent these illnesses by not having a sedentary lifestyle and not becoming obese.”

Dr. Muhonen offers some dietary and exercise tips for parents to establish heart-healthy habits for their children:

  • Avoid soda, juice and other sugar-sweetened drinks; offer the kids fat-free milk at meals and water the rest of the day. “You should avoid drinking your calories,” Dr. Muhonen says.
  •  Children should eat three meals a day with snacks of fruits and vegetables in between.
  • Don’t let the children skip meals. Skipping meals can lead them to overeat at the next meal and can slow down your metabolism.
  • Have kids take their lunch to school instead of buying lunch. Pack a heart-healthy lunch such as a tuna or turkey sandwich on whole wheat bread with a piece of fruit and some pretzels or string cheese, and a bottle of water.
  • Never reward children with food. Encourage kids to get an hour of physical activity each day. This can be whatever activity or sport interests the child. “You don’t need a gym membership or equipment to get some exercise,” she says.
  • Warn children about the dangers of cigarette smoking and encourage them never to start

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