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Interview with
Prof. Martin P. O´Laughlin |
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Martin P. O´Laughlin, M.D.,
Associate Professor,
Pediatric Cardiology,
Director Pediatric Cardiology
Catheterization Laboratory,
Duke University Med. Center,
Durham, North Carolina, USA |
| Prof.
Martin P. O´Laughlin |
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"What are the normal heart
rates at rest for babies, children and teenagers and why are they
different ?" |
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There are varying normal ranges
for many age groups, including 7 divisions just in the first year.
For a 3 to 5 month old infant, the normal range is 106 to 186 beats
per minute. For a 5 to 7 year old, the range is 65 to 113, and for
a teenager the range is the same as for an adult, 60 to 119 beats
per minute. There are differences (and overlap) because of differing
demands of the body on the heart. Changes in heart output in an infant
will mostly be accomplished by changes in the heart rate. Older children
may be better able to compensate by increasing the volume pumped with
every heartbeat. |
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"A 10 year old boy is standing
for hours at a school gathering.
He says to his friend next to him "I'm seeing stars" and faints.
What could cause this fainting ?" |
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This problem as described
sounds as if it is a vasovagal episode or "simple faint". It is very
common in student, soldiers, and band members who may be standing
for prolonged periods of time. The patient will often feel nauseated
and sweaty, and appear cool, clammy and pale. He or she will usually
not sustain an injury. The person should be allowed to lie on the
ground (if in a safe area) and the feet should be propped up. Standing
the person up will often cause another faint. The problem is caused
by a pooling of blood in the large veins of the legs, which in turn
cuts down on the amount of blood the heart has to pump to the vital
organs such as the brain. |
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"What examinations of the
heart are recommended before children and teenagers participate in
competitive sports ?" |
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It depends on the patient
and the level of sports contemplated. For intrascholastic and interscholastic
sports, a general physical examination with attention to the cardiovascular
and musculoskeletal systems is recommended. If the patient has any
signs or symptoms which might point to the cardiovascular system,
such as high blood pressure or a heart murmur, then cardiology consultation
should be considered. The testing then will again depend on the history
and physical examination of the patient, but might include an electrocardiogram,
a chest radiograph, and/or an echocardiogram. |
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