Use of the Electrocardiogram in a Pediatric Emergency Department

Horton, Lisa; Mosee, Sheila; Brenner, Joel I.

doi:10.1001/archpedi.1994.02170020070012

Cited by 34 publications

(23 citation statements)

References 8 publications

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“…A patient series of 71 ECGs performed in a pediatric ED found an alarming 32% of the ECGs being interpreted differently by the cardiologist, with 20% having potential clinical relevance. 1 A study evaluating the effect of the cardiologist review of ED ECG interpretations in an adult population was recently performed on a much larger number of ECGs (n=1,000), which is closer to our study numbers. 4 They found a discordance rate of 19%, which compared to our rate of 13%.…”

Section: Discussionsupporting

confidence: 77%

Accuracy of ECG Interpretation in the Pediatric Emergency Department

Wathen¹,

Rewers²,

Yetman³

et al. 2005

Annals of Emergency Medicine

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Section: Discussionsupporting

confidence: 77%

Accuracy of ECG Interpretation in the Pediatric Emergency Department

Wathen¹,

Rewers²,

Yetman³

et al. 2005

Annals of Emergency Medicine

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“…ECGs are obtained in children in the ED for a variety of reasons. Up to 20% of these have clinically significant findings such as prolonged QT syndrome, ventricular hypertrophy, or ectopy (1). Part of the challenge of pediatric ECGs is the fact that typically "abnormal" electrocardiographic findings in adults may, in fact, be normal or expected findings in children, depending on the age of the patient.…”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic Manifestations: Pediatric ECG

Chan

Sharieff

Brady

2008

The Journal of Emergency Medicine

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“…4 Chest pain presents a significant clinical burden for the pediatric emergency room physician 5 and is one of the more common reasons for performing electrocardiograms in the PED. 6 It is also a frequent cause for seeking pediatric cardiologist consultation within the hospital setting 7 and is among the most common reasons for referral to the pediatric cardiologist. 8 Prior to adulthood, chest pain is only rarely an indication of cardiac disease.…”

mentioning

confidence: 99%

Psychopathology and Disability in Children With Unexplained Chest Pain Presenting to the Pediatric Emergency Department

Lipsitz¹,

Gur²,

Sonnet³

et al. 2010

Pediatric Emergency Care

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Objective: Chest pain is a common presentation in the pediatric emergency department (PED). In the majority of cases, no clear medical cause is found. Among adults with noncardiac chest pain, psychopathology including panic disorder is common. We assessed the likelihood and type of psychopathology as well as the health status of children and adolescents with unexplained chest pain who presented to the PED.Methods: We performed a semistructured diagnostic interview of children 8 to 17 years old who presented to an urban, tertiary-care PED with a primary complaint of chest pain for which no medical cause was found. We used Diagnostic Statistical Manual of Mental Disorders, Fourth Edition criteria to diagnose psychopathology. We also assessed pain severity, extent of other somatic complaints, quality of life, and functional disability using standard, validated instruments. Results:We enrolled 32 children with a mean age of 12.8 (SD, 2.9) years (range, 8Y17 years); 47% were female. Twenty-six (81%) were diagnosed with a Diagnostic Statistical Manual of Mental Disorders, Fourth Edition anxiety disorder; 9 (28%) had full-criteria panic disorder. Quality of life was compromised in multiple domains, and children reported a range of functional disabilities due to chest pain. Other somatic symptoms, including other pain complaints, were commonly reported in this sample.Conclusion: Unexplained chest pain in the PED is frequently associated with potentially treatable anxiety disorders. Emergency physicians should consider the possibility of anxiety disorders in patients with medically unexplained chest pain.C hest pain is a common complaint in the pediatric emergency department (PED). 1Y3 Annually, it accounts for roughly 400,000 emergency visits in the United States for individuals 18 years or younger. 4 Chest pain presents a significant clinical burden for the pediatric emergency room physician 5 and is one of the more common reasons for performing electrocardiograms in the PED. 6 It is also a frequent cause for seeking pediatric cardiologist consultation within the hospital setting 7 and is among the most common reasons for referral to the pediatric cardiologist. 8 Prior to adulthood, chest pain is only rarely an indication of cardiac disease. In studies of children with chest pain, prevalence of cardiac abnormalities ranges from 0% to 10%. 2,3,9Y11 Noncardiac medical diagnoses are common, including musculoskeletal conditions such as costochondritis, 12 pulmonary conditions such as asthma or pneumonia, 13,14 gastrointestinal illnesses, 15,16 or other identifiable causes such as cocaine use. 17 However, most cases have no clear medical explanation. 18 Despite the overall benign medical picture, pediatric chest pain often persists for years after the first visit to the PED or specialist. 19,20 Some children with chest pain make repeated visits for additional medical testing. 21 Many experience disability, including school absence and sleep abnormalities. 2,19,22 Our objective was to conduct a pilot study to determine the li...

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Use of the Electrocardiogram in a Pediatric Emergency Department

Cited by 34 publications

References 8 publications

Accuracy of ECG Interpretation in the Pediatric Emergency Department

Accuracy of ECG Interpretation in the Pediatric Emergency Department

Electrocardiographic Manifestations: Pediatric ECG

Psychopathology and Disability in Children With Unexplained Chest Pain Presenting to the Pediatric Emergency Department

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