Exercise testing in children and young adults: an overview.
This chapter has demonstrated the diagnostic capability and feasibility of documenting functional abnormalities during dynamic stress in a pediatric population. The overview confirms that a controlled exercise procedure can be performed routinely in ambulatory children with or without cardiovascular disease and should be included in the clinical evaluation of specific lesions. It now appears that the primary indications for noninvasive exercise testing in the pediatric population include the following disorders: 1. Left ventricular outflow obstructions, a. Subvalvar obstructions, b. Valvar obstructions, c. Supravalvar obstructions, d. Idiopathic hypertrophic subaortic stenosis, e. Coarctation of the aorta; 2. Chronic left or right ventricular volume overload, a. Atrioventricular or semilunar valve incompetence, b. Left-to-right shunts; 3. Rhythm and conduction disturbances, a. Postoperative ventriculotomy, b. Bradytachyarrhythmias, c. Arrhythmias in patients with or without symptoms. The role of the exercise procedure is not yet established in the following areas: 1. Patients with family history of premature atherosclerosis or Type II hyperlipoproteinemia; 2. Patients with elevated blood pressure; 3. The evaluation of syncope, chest pain, or atypical findings on physical examinations (especially in athletes). Consequent upon increased interest and improved technology, the role of this technique will soon be established in the invasive and noninvasive evaluation of pediatric patients with or without overt cardiovascular disease.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001017:Aortic Coarctation / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000503:physiopathology; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D002648:Child; D004562:Electrocardiography; D005080:Exercise Test / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D013771:Tetralogy of Fallot / Q000503:physiopathology