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.

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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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Patient Returns to School Symptom-Free

Jaden picWhen Jaden Rascon started fourth grade earlier this week, she didn’t have to worry any longer about her heartbeat suddenly racing – thanks to an innovative procedure at CHOC Children’s.

“I feel good,” the 9-year-old says. “Before, when my heart would speed up, it was very hard to breathe, and it would give me headaches. But now it’s all gone because I got the procedure.”

Jaden recently underwent an outpatient electrophysiology procedure at CHOC to cure her arrhythmia. The experience was short, non-invasive and – even better – required no radiation.

Her procedure is a landmark achievement that signals a new direction for electrophysiology, a field that has already dramatically changed cardiology.  And now, an electrophysiology procedure with no radiation marks an even safer and less invasive cure for a common ailment.

A three-dimensional image of a heart created by cardio-mapping equipment at CHOC Children's.
A three-dimensional image of a heart created by cardio-mapping equipment at CHOC Children’s.

The successful radiation-free electrophysiology procedure is a credit to the skill and expertise of Dr. Anjan Batra, medical director of electrophysiology at the CHOC Children’s Heart Institute, as well as the state-of-the-art cardio mapping equipment inside the hospital’s new Bill Holmes Tower.

“This has really changed our field,” Dr. Batra said. “We can do so much more, and do it better and safer. It’s great to be in a field where we not only treat, but also cure. It’s great to help a patient so that they don’t have to see a doctor for the condition again.”

Dr. Batra performed the procedure using a three-dimensional cardio mapping system. The device uses catheters with locator sensors that transmit signals from inside the heart. This allowed Dr. Batra to visualize the beating heart by using these magnetic sources as reference points, rather than relying on fluoroscopy – an imaging technique that uses X-rays to obtain images of internal organs while they’re in motion – to reveal the catheters’ positions.

Just weeks after her procedure, Jaden’s quality of life has already improved.

Last November, Jaden began complaining of a rapid heartbeat, says her mother, Vera.  A normal resting heart rate for children ages 7 to 9 is between 70 and 110 beats per minute, but Jaden experienced a heart rate of 225 beats per minute during one emergency department visit. She was then referred to CHOC, and was subsequently determined to be a good candidate for an electrophysiology procedure.

“I was nervous at first,” Jaden says, “but then I knew that they were studying the heart for a long time so nothing would go wrong.”

Typically, up to three patients are diagnosed with arrhythmias each day at CHOC, Dr. Batra says.  About 25 years ago, the only cure for these conditions was open heart surgery, and many patients simply tolerated the condition or relied on medication.

Now, the hospital has used electrophysiology procedures to cure more than 100 children with arrhythmias each year, and that figure is expected to increase as awareness grows among parents and the medical community, says Dr. Batra, one of about 200 pediatric electrophysiologists worldwide.

Learn more about CHOC’s electrophysiology services.

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CVICU Provides Special Post-Procedure Care to Heart Patients

Patients who have undergone complex, cardiovascular procedures at the CHOC Children’s Heart Institute require specialized care and attention. At CHOC, they get just that in a dedicated, 12-bed Cardiovascular Intensive Care Unit (CVICU).

In CHOC’s CVICU, children receive attention from pediatric cardiac-trained intensivists, nurse practitioners, critical-care registered nurses, and an interdisciplinary medical team. All rooms are private and fully equipped with leading-edge technology that meets the demands of monitoring and treating children with heart problems, and those who have undergone complex heart surgery and heart catheterization procedures. CHOC is the only facility in Orange County that performs open heart surgery on newborns and children.

That combination of well-trained experts and topnotch facilities can lead to improved patient outcomes. The Heart Institute has outcomes above the national averages for overall survival rate and neonatal survival rate. CHOC is routinely named to the Leapfrog Group’s annual list of Top Children’s Hospitals, recognizing a commitment to provide the safest and highest quality of health care.

“Cardiovascular patients are unique and delicate. They require complex care and management. CVICU staff members understand these kids’ physiology,” says Allie Quill, RN, a clinical outcomes coordinator at CHOC. “When our patients get into trouble, their treatment is not routine. All of our kids are so different and require such fine tuning.”

CVICU care team

Cardiac pediatric subspecialists are especially trained to care for heart patients in need of critical care, and they have advanced knowledge of cardiovascular disorders.

“Pediatric heart specialists have extra training and experience in caring for children with unique and severe cardiac disorders, something a general care team or an adult cardiac doctor may not be as comfortable with,” says Dr. Michele Domico, medical director of the CVICU.

The CVICU’s design also plays a critical role in improving outcomes for patients. The space encourages parent-clinical caregiver interaction, and ensures a peaceful, healing environment.  Our staff recognizes the role that loved ones play in patient healing.

Each private CVICU patient room is divided into three areas:

  • The first area, closest to the doorway, is the nurse’s zone. Here, visitors will notice a wheeled cart that holds a computer and supplies to allow bedside charting and full access to patients.
  • The second area belongs to the patient, and features gas hook-ups, monitors and other equipment.
  • The third area is the parent zone, which includes a sleep sofa, reading light, sink, telephone and other amenities to ensure family comfort.

The CHOC CVICU also includes two fully-equipped procedure rooms that allow physicians to perform life-saving surgery on patients who otherwise could not be transported out of the unit.

Certain heart conditions warrant a series of surgeries throughout childhood, necessitating several stays in the CVICU. For that reason, CVICU staff members often develop close and lasting relationships with patients and families.

“Parents often come back and visit us after their child has been discharged, to thank us for taking special care of their child,” says Domico. “Every year our team receives dozens of school photos and holiday cards from families who we were fortunate enough to bond with in the CVICU. It’s a privilege to see the children we’ve treated grow up and have a healthy childhood.”

Learn more about CHOC’s CVICU.

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