Exercise-limiting symptoms in children.

Transient exercise-related symptoms are common in children and adolescents and only rarely reflect underlying cardiac and pulmonary disease processes. Most symptoms occurring during exercise reflect changes related to normal exercise physiology, changes in level of competition, and musculoskeletal and developmental factors. A rational approach to screening for potentially life-threatening cardiac conditions and exercise-induced bronchospasm is important to minimize the risk of misdiagnosis and to keep the young athlete active.

Intracardiac yolk sac tumor and dysrhythmia as an etiology of pediatric syncope.

This report describes a new etiology of pediatric syncope. Epilepsy, brain anomalies, infection, electrolyte abnormalities, and trauma are commonly identified etiologies of seizures in the pediatric population. We report here a child with third-degree heart block and right ventricular outflow tract obstruction related to an intracardiac tumor presenting with syncope and seizure-like activity.

Hepatic dysfunction following the Fontan procedure.

Objectives: The Fontan procedure offers a palliation for the hemodynamic derangements associated with congenital heart lesions characterized by a single functional ventricle, but it causes a chronically elevated systemic venous pressure that may result in hepatic congestion. The objective of this study was to characterize hepatic function and its relationship to cardiac function in children who had undergone the Fontan procedure.

Methods: In a cross-sectional study of 11 children aged 38 months to 216 months (mean, 149 months), the authors evaluated indices of cardiac and hepatic function, including galactose clearance, Doppler hepatic ultrasonography, synthetic function, and markers of liver injury, at 9 months to 176 months (mean, 100 months) after children had undergone the Fontan procedure.