HJNO Mar/Apr 2021

HEALTHCARE JOURNAL OF NEW ORLEANS  I  MAR / APR 2021 39 children with complex heart disease may also have developmental and learning dis- abilities. Multidisciplinary clinics specific of neurodevelopment provide extensive diagnostic evaluations to detect these problems and offer management strate- gies to help correct them. 6. Home monitoring follows the sickest of complex congenital heart disease babies at home After surgery, some very young babies with particularly complex heart problems require intensive monitoring after dis- charge. To help parents care for these frag- ile babies, a “homemonitoring team”meets frequently with parents during the days leading up to discharge from the hospital to ensure that parents are trained to care for their baby at home and are comfortable in doing so. Once discharged, the home monitoring team partners with parents in the outpatient care of their baby. The home monitoring team regularly contacts the family to review how the baby is doing at home. This helps potential problems be identified early, and appropriate manage- ment can be immediately instituted. 7. Multisystem inflammatory syndrome in children (MIS-C) MIS-C is believed to occur due to an overly revved-up immune system response in the weeks following the COVID-19 infection. MIS-C can cause in- flammation and compromise the function of many different organs in the body, in- cluding the heart, the kidneys, the liver and the gastrointestinal tract. Although most children experiencing MIS-C test posi- Thomas Kimball, MD Heart Center Co-Director & Chief of Pediatric Cardiology Children’s Hospital New Orleans of their assessment includes ordering an electrocardiogram (EKG). Education of pediatric practitioners on EKG interpre- tation drastically improves their ability to distinguish normal from abnormal find- ings and to identify specific abnormalities, allowing for earlier referral, intervention and treatment. This is an important area of focus for continuing medical education and training and teaching for new pediat- ric practitioners. 4. School preparedness for sudden cardiac arrest Since even the most robust pre-partici- pation athletic screening programs will not identify every adolescent at risk for sudden cardiac arrest on the athletic field, efforts must simultaneously focus on school pre- paredness. Increasing rates of cardiac ar- rest has prompted many states to pass a law requiring cardiopulmonary resuscita- tion (CPR) training for high school gradu- ation and requiring schools to have and to know how to use automated external de- fibrillators. Training our school communi- ties on use of these lifesaving tools, as well as how to recognize the signs and symp- toms of cardiac arrest, will help save lives. 5. Neurodevelopment in babies and children with congenital heart disease Often, children have such unique heart problems that they require extra special and sophisticated care. Recognizing this, sub-specialty clinics and services to care for these patients is critical. Due to their heart problem or the effects of undergoing complicated heart surgery as babies, some tive for COVID-19, some do not. Parents should watch for fever, a red and blotchy rash, diarrhea and vomiting as signs of MIS-C. If these symptoms develop, par- ents should bring their child to the near- est emergency department immediately. Fortunately, MIS-C is rare, and although children can become very sick, there are effective treatments, and almost all chil- dren recover. These treatments include intravenous medications of general (non- COVID) antibodies and steroids. 8. Obesity among children is a major risk factor of serious health conditions, including heart disease Obesity is increasing in prevalence across the United States, representing 13.5% of children two to five years, 18.4% of children six to 11 years, and 20.6% of ages 12 to 19 years. Obesity is a major risk factor for serious health conditions such as heart disease, and over the past 40 years, rates in children have tripled. 30% of children do not exercise three or more times per week, and obese children have an 80% chance of becoming obese adults. Good nutrition and physical activity can help, but oppor- tunities may be limited in many of our communities. n Thomas Kimball, MD, is the co-director of The Heart Center and division chief of cardiology at Children’s Hospital New Orleans. A native of Oakland, California, he received his under- graduate degree at Stanford University and went on to earn his medical degree from New York University. He then completed pediatric residency training at Children’s Hospital of Los Angeles, followed by a cardiology fellow- ship at Cincinnati Children’s Hospital. Kimball remained at Cincinnati Children’s Hospital serving as an attending cardiologist for 34 years.