Tuesday, December 16, 2014

2Min Tuesday: Pediatric Cardiology Q&A

Welcome to today's Two minute Tuesday, brought to you by Chad Rudnick, M.D. and Boca VIPediatrics!  Join us for two minutes as we interview some of the top experts in pediatrics & parenting.

In today's segment, we welcome Dr. Michael Fundora of the Miami Children's Hospital division of pediatric cardiology. During my interview with Dr. Fundora, learn about how research is showing that heart conditions previously thought only to occur in adults actually begins with risk factors during childhood. Learn about ways to prevent heart disease starting now with your child. Also, see what Dr. Fundora prescribes to every one of his patients in the cardiology clinic at Miami Children's Hospital.

  A lot of children are told they have a murmur, what is a murmur and are they always dangerous?

 A murmur isn’t always dangerous. As a matter of fact, most murmurs are what we call "innocent murmurs". This means that in young children, because they are smaller than adults, doctors can hear the blood flowing through and bouncing off the walls of the heart. However, some murmurs are more concerning. They can indicate that there is a hole between the chambers of the heart or that there is a problem with the valves. Usually when a murmur is heard, pediatrician's can tell if it is an "innocent" or worrisome murmur. In those cases, they usually refer the child to see a pediatric cardiologist.

What are warning signs that a child’s chest pain may be coming from an issue with their heart?

Chest pain in children is a very common complaint. That said, chest pain in children due to a heart problem is very rare. Generally, if the pain is severe or persistant you should see your doctor. Some red flags would be chest pain while exercising or feeling an irregular heart beat or palpitations when there is chest pain. Very simply, if the chest pain makes the parent's worried, then they should see a doctor and be evaluated.

What is the most common misconception (or question you get asked) that parents have about pediatric cardiology?

I would say the most common misconception parents have about pediatric cardiology is mostly surprise that children can have heart problems. Usually people think of heart problems in adults, however many children are born with hearts that didn't develop properly while in the womb. However, many kids can also develop heart problems such as arrhythmias or enlarged heart. With new technology, we are better than ever at diagnosing at treating these patients.  Many times, abnormalities with a child’s heart can be detected via ultrasound during pregnancy. We are also starting to realize that many of these heart problems are actually genetic and we can test for them in entire families.

What are some tips for children who have a family history of heart disease, heart attacks, or high cholesterol, to stay healthy starting at an early age?

 I would say that this is one of the new frontiers in pediatric cardiology. Research is starting to show that many of the adult problems that we see such as high cholesterol, high blood pressure, and obesity are actually starting in childhood or that the risk factors begin at a young age. Everyone, especially children should begin good exercise and eating habits at a young age. I tell my patients that exercise is the most powerful medicine we have and the only medicine that we know for sure will lead to a longer and healthy life. I "prescribe" it to all my patients and I tell the parents of my patients to think of it that way.

In the cases where there is a strong family history of heart disease, high cholesterol or high blood pressure, parent's should make sure they have their child see their pediatrician for their well child checks. As kids get older and get past the vaccine stage, some parents tend to only see their pediatrician when their child is sick, but evaluating them when they're healthy can help doctors uncover any other problem and further investigate and refer to a cardiologist.

Should my child have a screening EKG before starting sports and why?

YES! All kids should have a screening EKG before they start competitive sports. Many people ask me why they should get one if their child has always been heathy. When we do a screening EKG, pediatric cardiologists are searching for specific signs that we know put children at risk when they do strenous activity. These signs on the EKG can lead to arrhythmias which many times are fatal. All too often, we only hear about these cases after there has been a tragedy on the field. If an abnormality is found, we can further investigate and treat the problem before it’s too late. Often there are relatively simple procedures or medications that can be started that can save lives.

Meet Our 2-Minute Tuesday Expert this Week:
Dr. Michael Fundora is a board certified pediatrician. Originally from New York, Dr. Fundora completed his residency at Miami Children’s Hospital and is currently a Fellow in Pediatric Cardiology at The Heart Program of Miami Children’s Hospital. He is a clinical instructor at the Herbert Wertheim College of Medicine at Florida International University. He is a recipient of the Ramon Rodriguez-Torres award for the care of medically complex children as well as awards in scholarship for original research. He is a regular lecturer on topics in pediatric cardiology and has presented several research abstracts on complex congenital heart disease at international conferences at Duke University and Emory University. His current research focuses on the technical aspects of complex congenital cardiac disease as well as quality improvement.


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  1. I never thought about my child having a screening EKG before starting sports. After reading this, I understand how important it is and how much it could help. I'll have to call over to my local pediatric cardiologist to see if he has an available appointment. Hopefully I can get them in before baseball season! http://childrenscardio.com/services.html

  2. Going along with murmurs, do the cardiologists meet with these people all the time to monitor their heart? I know a few people that have had heart murmurs and they really don't talk about going in. In fact, a lot of them don't even act like anything is wrong. Learning about them in class, I thought that they would be something that cardiologists would like to keep an eye on, but I am not sure if that is what they really do. http://childrenscardio.com/providers.html