Question: Cardiology

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Kelly October 1, 2022 - 2:45 pm Reply

D) Cardiomegaly on CXR raises concerns for CHF, and is defined as a cardiac width > 55% of the transthoracic width on the PA view of the CXR
Children with CHF often present with poor feeding (taking longer than other infants, sweating with feeding) and failure to thrive, tachypnea (but no hypernea) and increased work of breathing (e.g. retractions), wheezing / crackles, and hepatomegaly. Unlike adults, peripheral edema and visible jugular venous distension are difficult to appreciate. Volume overload congenital heart lesions commonly present ~6-8 weeks of life, as the pulmonary vascular resistance falls, leading to more left to right shunting. The most common cause of pediatric CHF in a structurally normal heart is cardiomyopathy. BNP levels > 100 pg/mL are associated with CHF in children as well as adults, although neonatal BNP normal may be slightly higher.