Pediatric Cardiology Evaluation for: Angel Alberto Lopez Perez
DOB: 5/19/06
History: 5 month old with murmur and FTT.
PMHx:
Medications: digoxin, spironolactone
P: RR: BP: SaO2: 90%
GEN: somewhat dysmorphic HEART:
Active precordium, III/VI high pitched SEM @ LUSB, No rubs, clicks or gallopHEENT: MMM, Nl dentition
LUNGS: CTA b/l w/o W/R/R
ABD: Soft, w/o liver 3 cm
EXT:W & WP, Nl distal pulses
CXR: tet like cardiac sillouette
ECHO:
Situs: solitus
Systemic and PulmonaryVeins: Normal connections
Atrial Septum: PFO
Ventricular Septum: malaligned VSD
Aortic valve: Normal
Pulmonary Valve and Artery: PS with 50mmHg gradient, infundibulum somewhat narrow, branch PAs OK.
Mitral Valve: Normal
Tricuspid Valve: Physiologic TR
Aortic Arch: leftward, no coarctation, no PDA
Impression: Tetralogy of Fallot with FTT and likely TORCH, h/o congenital cataract and Dev delay
Recommendation: good surgical candidate during the first year of life from a cardiovascular standpoint, would like to see him gaining weight prior to surgical repair as well as further delineation of possible sequellae from TORCH. Would start propranolol 2mg/kg/day divided TID. Stop digoxin and spironolactone
Kirk A. Milhoan, MD, PhD
Pediatric Cardiology Evaluation for: AVILES BRANDON
DOB: 9/20/01
History: ASYMPTOMATIC
PMHx:
Medications:NONE
P: RR: BP:90/70 SaO2: %
GEN: Nondysmorphic HEART:
Normal precordium, no thrills, RRR, Nl S1 and S2; No clicks, rubs or gallopsHEENT: MMM, Nl dentition
LUNGS: CTA b/l w/o W/R/R
ABD: Soft, w/o HSM
EXT:W & WP, Nl distal pulses
ECHO:
Situs: solitus
Systemic and PulmonaryVeins: Normal connections
Atrial Septum: intact
Ventricular Septum: VERY RESTRICTIVE VSD, PSG 115mmHg,
Aortic valve: Partially closing subaortic VSD, with trivial AI
Pulmonary Valve and Artery: Normal
Mitral Valve: Normal
Tricuspid Valve: Physiologic TR
Aortic Arch: leftward, no coarctation, no PDA
Impression: SUBAORTIC VSD WITH TRIVIAL AI
Recommendation: WE RECOMMEND SURGICAL CLOSURE WITHIN THE NEXT 2 YEARS
Kirk A. Milhoan, MD, PhD
DOB: 9/20/01
History: ASYMPTOMATIC
PMHx:
Medications:NONE
P: RR: BP:90/70 SaO2: %
GEN: Nondysmorphic HEART:
Normal precordium, no thrills, RRR, Nl S1 and S2; No clicks, rubs or gallopsHEENT: MMM, Nl dentition
LUNGS: CTA b/l w/o W/R/R
ABD: Soft, w/o HSM
EXT:W & WP, Nl distal pulses
ECHO:
Situs: solitus
Systemic and PulmonaryVeins: Normal connections
Atrial Septum: intact
Ventricular Septum: VERY RESTRICTIVE VSD, PSG 115mmHg,
Aortic valve: Partially closing subaortic VSD, with trivial AI
Pulmonary Valve and Artery: Normal
Mitral Valve: Normal
Tricuspid Valve: Physiologic TR
Aortic Arch: leftward, no coarctation, no PDA
Impression: SUBAORTIC VSD WITH TRIVIAL AI
Recommendation: WE RECOMMEND SURGICAL CLOSURE WITHIN THE NEXT 2 YEARS
Kirk A. Milhoan, MD, PhD
DOB: 04/03/05
History:SHORTNESS OF BREATH
PMHx:
Medications:CAPTOPRIL, LASIX
P: RR: BP: SaO2: 97%
GEN: Nondysmorphic HEART:
Active precordium, no thrills, RRR, Nl S1 and loud S2; III/VI HSM @ LLSB, unable to detect diastolic rumble due to crying. No clicks, rubs or gallopsHEENT: MMM, Nl dentition
LUNGS: CTA b/l w/o W/R/R
ABD: Soft, liver down 2cm
EXT:W & WP, Nl distal pulses
ECHO:
Situs: solitus
Systemic and PulmonaryVeins: Normal connections
Atrial Septum: intact
Ventricular Septum: Flattened. Unrestrictive subaortic VSD, PSG 37mmHg
Aortic valve: Normal
Pulmonary Valve and Artery: Normal
Mitral Valve: Normal
Tricuspid Valve: Physiologic TR
Aortic Arch: leftward, no coarctation, no PDA
Impression: Unrestrictive VSD with mild signs of CHF
Recommendation: Surgical repair in the next 6 months, should be the first child to receive surgery from this screening
Kirk A. Milhoan, MD, PhD
History:SHORTNESS OF BREATH
PMHx:
Medications:CAPTOPRIL, LASIX
P: RR: BP: SaO2: 97%
GEN: Nondysmorphic HEART:
Active precordium, no thrills, RRR, Nl S1 and loud S2; III/VI HSM @ LLSB, unable to detect diastolic rumble due to crying. No clicks, rubs or gallopsHEENT: MMM, Nl dentition
LUNGS: CTA b/l w/o W/R/R
ABD: Soft, liver down 2cm
EXT:W & WP, Nl distal pulses
ECHO:
Situs: solitus
Systemic and PulmonaryVeins: Normal connections
Atrial Septum: intact
Ventricular Septum: Flattened. Unrestrictive subaortic VSD, PSG 37mmHg
Aortic valve: Normal
Pulmonary Valve and Artery: Normal
Mitral Valve: Normal
Tricuspid Valve: Physiologic TR
Aortic Arch: leftward, no coarctation, no PDA
Impression: Unrestrictive VSD with mild signs of CHF
Recommendation: Surgical repair in the next 6 months, should be the first child to receive surgery from this screening
Kirk A. Milhoan, MD, PhD
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