Exercise Physiology for the Pediatric and Congenital Cardiologist

Description

This book provides a comprehensive overview of exercise physiology in patients with congenital heart disease and other pediatric cardiopulmonary disorders. It begins with an in-depth but pragmatic discussion of exercise physiology and the cardiopulmonary adaptations to physical activity, followed by a review of the conduct and interpretation of cardiopulmonary exercise tests. Subsequent chapters discuss exercise physiology and testing in patients with a variety of congenital heart diseases, including tetralogy of Fallot, Fontan physiology, transposition of the great arteries, aortic valve disease, and coarctation of the aorta. Additional chapters analyze other conditions commonly encountered by pediatric and congenital cardiologists such as pulmonary vascular disease, cardiomyopathies, heart transplants, and metabolic disorders. The book also examines the role of exercise testing in patients with electrophysiologic issues such as Wolff-Parkinson-White Syndrome, long QT syndrome, atrioventricular node dysfunction, and pacemakers. The presentations are enhanced by data from Boston Children’s Hospital’s vast experience with clinical exercise testing. The textbook concludes with a series of interesting and illustrative cases that build on the earlier chapters, present some fascinating physiology, and provide real-world examples of how exercise testing can inform clinical decision making. Exercise Physiology for the Pediatric and Congenital Cardiologist is a detailed, practical reference for clinicians and other health care providers engaged in exercise testing for children and adults with congenital heart disease and other conditions that may be encountered by the pediatric and congenital cardiologist. It is an essential resource for physicians, medical students, and exercise physiologists as well as researchers in cardiology, pediatrics, and cardiopulmonary fitness.. Front Matter ....Pages i-xvii Front Matter ....Pages 1-1 Biochemistry of Exercise (Jonathan Rhodes)....Pages 3-4 Oxygen Delivery (Jonathan Rhodes)....Pages 5-9 Central Hemodynamics and Coronary Blood Flow During Exercise (Jonathan Rhodes)....Pages 11-14 CO2 Elimination (V̇CO2) (Jonathan Rhodes)....Pages 15-17 Front Matter ....Pages 19-19 Laboratory Setup, Equipment, and Protocols (Julieann O’Neill, Laura Bourette)....Pages 21-28 Exercise Stress Echocardiography (Iqbal El-Assaad, Keri M. Shafer, Ming Hui Chen)....Pages 29-35 Other Modalities: Assessment of Pulmonary Response and Measurement of Cardiac Output (Alexander R. Opotowsky, Jonathan Rhodes)....Pages 37-41 Supervision and Safety Precautions for Exercise Testing (Tracy J. Curran)....Pages 43-45 Special Considerations for Children (Jennifer L. Pymm)....Pages 47-48 Special Considerations for Adults with Congenital Heart Disease (Jennifer L. Pymm)....Pages 49-50 Front Matter ....Pages 51-51 Peak Exercise Parameters (Jonathan Rhodes)....Pages 53-64 Parameters from Submaximal Exercise (Jonathan Rhodes)....Pages 65-74 Putting It All Together (Jonathan Rhodes)....Pages 75-79 Front Matter ....Pages 81-81 Repaired Tetralogy of Fallot (Jonathan Rhodes, Alexander R. Opotowsky, Mark E. Alexander)....Pages 83-95 Fontan Circulation (Jonathan Rhodes, Alexander R. Opotowsky)....Pages 97-115 Aortic Valve Disease (Jonathan Rhodes)....Pages 117-123 Coarctation of the Aorta (Jonathan Rhodes, Alexander R. Opotowsky)....Pages 125-130 Systemic Right Ventricles with a Biventricular Circulation (L-Transposition and D-Transposition After Atrial Switch Operation) (Alexander R. Opotowsky)....Pages 131-138 D-Transposition s/p Arterial Switch Operation (Jonathan Rhodes, Alexander R. Opotowsky)....Pages 139-144 Ebstein’s Anomaly (Jonathan Rhodes, Alexander R. Opotowsky)....Pages 145-151 Pulmonary Vascular Disease (Jonathan Rhodes, Alexander R. Opotowsky)....Pages 153-161 Exercise Testing in Pediatric Dilated Cardiomyopathy (Irene D. Lytrivi, T. P. Singh)....Pages 163-168 Hypertrophic Cardiomyopathy (Renee Margossian, Jonathan Rhodes)....Pages 169-177 Coronary Anomalies (Jennifer Huang, Keri M. Shafer)....Pages 179-185 Metabolic Disorders (Jonathan Rhodes)....Pages 187-193 Exercise Testing After Pediatric Heart Transplantation (Arene Butto, T. P. Singh)....Pages 195-200 Cardiac Rehabilitation and Exercise Training (Ana Ubeda-Tikkanen, Naomi S. Gauthier)....Pages 201-208 Summary of Lesions (Jonathan Rhodes)....Pages 209-210 Front Matter ....Pages 211-211 Syncope, Orthostatic Intolerance, and Exertional Symptoms (Mark E. Alexander)....Pages 213-218 Exercise Stress Testing: Diagnostic Utility in the Evaluation of Long QT Syndrome (Stephanie F. Chandler, Robyn J. Hylind, Dominic J. Abrams)....Pages 219-226 Wolff-Parkinson-White Syndrome (Tam Dan N. Pham, Mark E. Alexander)....Pages 227-234 Exercise Testing in the Management of Arrhythmias (Audrey Dionne, Edward T. O’Leary, Shankar Baskar, Vassilios J. Bezzerides, Mark E. Alexander)....Pages 235-255 Front Matter ....Pages 257-257 Patients with Physiologically Normal Hearts and Lungs (Jonathan Rhodes)....Pages 259-275 Patients with Unusual Congenital Heart Defects and/or Intracardiac Shunts (Jonathan Rhodes)....Pages 277-304 Patients with Significant Lung Disease (Jonathan Rhodes)....Pages 305-319 Back Matter ....Pages 321-330