Heart failure secondary to dilated cardiomyopathy: a role for emergency physician bedside ultrasonography.
Heart failure as a result of cardiomyopathy is an uncommon presentation in the pediatric emergency department (PED). The initial presenting symptoms in these cases are often nonspecific and may be confused with more common pediatric illnesses. We report a case of a 3-year-old girl initially discharged from a PED after routine evaluation of vomiting and diarrhea with a diagnosis of acute gastroenteritis only to return 1 week later in heart failure from a dilated cardiomyopathy. A bedside ultrasound performed by the emergency physician in the PED allowed for the initiation of appropriate, rapid, goal-directed therapy and expedited timely transport to a facility with pediatric cardiothoracic surgery. We will review dilated cardiomyopathy and the role of emergency physician echocardiography.
Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Newark Beth Israel Medical Center, Children's Hospital of New Jersey, Newark, NJ, USA. asivitz@sbhcs.com
Adam
A
Sivitz
Arun
A
Nagdev
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D002675:Child, Preschool; D003951:Diagnostic Errors; D004280:Dobutamine / Q000627:therapeutic use; D004298:Dopamine / Q000627:therapeutic use; D004417:Dyspnea / Q000209:etiology; D004452:Echocardiography; D004487:Edema / Q000209:etiology; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D005759:Gastroenteritis / Q000150:complications; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006333:Heart Failure / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D016027:Heart Transplantation; D006801:Humans; D019095:Point-of-Care Systems; D014839:Vomiting / Q000209:etiology
D004280:Dobutamine; D004298:Dopamine