Self-Perception of Transition Readiness Amongst Pediatric Patients with Childhood Heart Disease.

This study assesses self-report of transition readiness among adolescents and young adults (ages 12-25 years) with childhood and congenital heart disease (CHD), receiving care at Hasbro Children's Hospital, whose CHD diagnosis warranted transfer to adult cardiology care. Patients were mailed the American Academy of Pediatrics/American College of Physicians Transition Readiness for Youth Assessment survey. Confidence scores ranged between 0 (not) and 10 (very). Mann-Whitney U test was used to assess differences in scores between younger (12-17 years) and older (18-25 years) groups. 396 patients met inclusion criteria; 88 surveys were returned. Half of respondents were in the older group. While most respondents felt empowered to take charge of their own health and equally confident about moving to adult care, this did not always translate to actual knowledge. Younger patients had statistically significant lower knowledge scores in these metrics. Aspects of care with low scores include medication refills, communication with primary care team, and the lifelong need for cardiology follow up and health insurance. This discrepancy between self-report and actual knowledge highlights the need for more varied and age appropriate interventions to help patients navigate a complex healthcare system. A concrete approach to acquire the knowledge necessary to ensure successful transfer to adult cardiology care should be a focus.

A neonate with high-outflow congestive heart failure and pulmonary hypertension due to an intracranial arteriovenous malformation.

Congestive heart failure in the newborn period is uncommon and is most commonly related to congenital structural heart disease. However, the differential diagnosis is broad and includes arrhythmias, congenital or acquired myopathies, sepsis, severe anemia, or other conditions leading to high-output cardiac failure. Here we report on a 4-day-old girl with high-output heart failure due to a congenital cerebral arteriovenous malformation.

Repair of ventricular septal defect and left ventricular aneurysm following blunt chest trauma.

In children, even minor trauma to the chest can result in cardiac injury. We describe a case of a 13-year-old boy who received blunt chest trauma during a motorcycle accident. He was initially symptom-free but later complained of persistent chest pain and a murmur was noted. An anterior muscular ventricular septal defect was detected one day after the accident, and a left ventricular pseudo-aneurysm developed days later. Both were successfully repaired 3 weeks after the injury.