Cardiac Evaluation - Take Good History First Video

Cardiac Evaluation - Take Good History First Andrew D. Blaufox, MD Pediatric Electrophysiology Schneider Children's Hospital . Associate Professor Clinical Pediatrics Albert Einstein College of Medicine. Medical School: Albert Einstein College ...
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Male Speaker: A very common question of pediatrician, my kid is going to play football or baseball high school, maybe even college, would you recommend any test that should be done before taking a good history. Andrew D. Blaufox: Recommendations for manpower association in which I also believe and then what you really need is a very good history in physical and there are -- Male Speaker: Oh! You mean the old standby still the best thing still. Andrew D. Blaufox: Well, I think the biggest problem with the old standby is that there aren't any real standards that each state sort of comes up with their own history. Male Speaker: But what key points if you took a very good history that we need to be looking for? Say, we have concern that we should do more than just take a history, what we would be looking for? Andrew D. Blaufox: So the most important things to be looking for, are history's suggested of any. So any history of palpitations. Male Speaker: It is a term that I know but maybe some don't. What is palpitations? Andrew D. Blaufox: Any history of abnormal sensation that your heart is being rapidly, any history of passing out particularly with exercise, any history of chest pain with exercise are key elements of the history. And then a strong family history is also very important; is there anyone in the family who died suddenly at a young age, died unexpectedly from some unknown causes and for that manner, anyone who is drowned, you might need to investigate more thoroughly. Drowning can occur as a mishap during swimming but it's also a prolong QT syndrome. Male Speaker: This is a very good point, since having this running, because they were bad swimmer, they could have had QT or some kind of -- they can lost consciousness and they are just drowned. Andrew D. Blaufox: Particularly a prolong QT syndrome is associated with the events during swimming. So you have to gather as much information as you can about that event. And then on the physical, you want to look for any signs of heart disease, any murmurs, any problems with blood pressure, any stigmata of Marfan syndrome or also things that you need to look for evaluating someone with the potential causes for sudden death. If any of these things make you suspicious, then an ECG would be indicated and potentially a pediatric cardiology consultation.

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