Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
What does a pediatric cardiologist do? For sure, they rarely
see problems that happen with adults -- kids just don't often
get heart attacks or need pacemakers. And for sure, they see a
lot of cases of heart malformations from birth. But there are
some diseases that occur in children that affect the heart
that are somewhat more common.
Kids get pericarditis and myocarditis, which are viral
infections of the covering of the heart and the muscles of the
heart, respectively. They both often do very well, but they
can be painful and require hospitalization for the cases that
go bad. Myocarditis is much more dangerous than pericarditis
in general.
Commotio Cordis is a scary new disease where a blow to the
chest can cause an abnormal heart rhythm and sudden death. We
are still learning about this problem, which can happen in
kids who are engaging in any contact sports or games with
balls.
Sudden death in young adults may also be due to the heart,
although this is also poorly understood. One thing we have
learned recently is about Brugada syndrome, a disease of the
heart that runs in the family where an EKG abnormality can
cause sudden death.
What does a pediatric pulmonologist do? Children's lungs are
more sensitive than adults, and they see a lot of asthma,
which can be tricky in kids. Fortunately, it improves with
age. Cystic fibrosis is also a disease they often see. It is
an inborn problem where there are multiple problems caused by
mucous plugging of the airways and salt abnormalities. These
children used to all die, but now many, if not most, make it
to adulthood.
Little babies, especially premature ones, can have BPD, which
is a problem of lung immaturity, but the discovery of
surfactant, the material that allows the diffusion of oxygen
into the blood stream, has made these children survive
longer.
Actually, aside from asthma, the most common problem they will
see is inspirated foreign bodies. Giving small objects,
especially nuts, to children is asking for trouble. Write me
in care of the Yated.
A message from Glaxo, sponsor of this column. How can
we speak about lungs without mentioning Glaxo's full line of
asthma drugs, which include the short acting broncodilator
(drug which opens up the breathing tubes) called Ventolin, and
the longer acting Serevent, both revolutionary in their
fields. They are not new -- they have stood the test of time
and are accepted as the standard in asthma therapy.
