During initial evaluation of children on an outpatient basis, the index of suspected heart disease may be high, particularly if we consider that innocent murmur occurs in about 50% of the pediatric population. 1-3 This is the most common cause of referral to the pediatric cardiologist, with several reports of such experience published worldwide. Other causes like chest pain, breathlessness at r...

I don’t know how the reader of this editorial is feeling, but I have become weary of the constant emphasis by the press, which includes television, concentrating on negatives in our society, whether it is the “War on Terrorism”, the War in Iraq, and yes, the recent November election. Recently, I had one of those “significant positive emotional events” that alleviated my perseveration on current...

UNLABELLED Physician led collaborative drug therapy management utilizing clinical pharmacists to aid in the medication management of patients with hypertension has been shown to improve blood pressure control. With recommendations for lower blood pressures in patients with coronary artery disease, a cardiologist-pharmacist collaborative care model may be a novel way to achieve these more rigoro...

ONE of the most frustrating and frequent problems faced by the pediatric cardiologist is that of differentiating between a child with mild and physiologically unimportant congenital aortic stenosis and one whose lesion is severe and therefore potentially dangerous. In an asymptomatic younger child with the typical murmur and thrill of aortic stenosis but no evidence of left ventricular hypertro...

Many normal children have heart murmurs, but most children do not have heart disease. An appropriate history and a properly conducted physical examination can identify children at increased risk for significant heart disease. Pathologic causes of systolic murmurs include atrial and ventricular septal defects, pulmonary or aortic outflow tract abnormalities, and patent ductus arteriosus. An atri...