Unequal blood pressures in the extremities and unequal brachial vs femoral pulses? Consider coarctation of the aorta. What’s that? Learn more in today's episode!

This episode was written by pediatricians Lidia Park and Tammy Yau with content support from Jay Yeh (UC Davis pediatric cardiologist). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• Coarctation of the aorta is narrowing of the aorta near the ductus arteriosus (which closes and becomes the ligamentum arteriosum). Most cases occur in the first month of life.
• Symptoms of coarctation of the aorta are tachypnea, poor feeding, fussiness, and sweating with feeds. Blood pressure is elevated in the right upper extremity compared to the lower extremity. Babies can develop congestive heart failure which can lead to shock.
• CCHD does not always catch coarctations of the aorta!

Sources:

• Raza S, Aggarwal S, Jenkins P, et al. Coarctation of the Aorta: Diagnosis and Management. Diagnostics (Basel). 2023;13(13):2189. Published 2023 Jun 27. doi:10.3390/diagnostics13132189
• Salciccioli KB, Zachariah JP. Coarctation of the Aorta: Modern Paradigms Across the Lifespan. Hypertension. 2023;80(10):1970-1979. doi:10.1161/HYPERTENSIONAHA.123.19454
• Parker LE, Landstrom AP. Genetic Etiology of Left-Sided Obstructive Heart Lesions: A Story in Development. J Am Heart Assoc. 2021;10(2):e019006. doi:10.1161/JAHA.120.019006

Does your child have a barking seal like cough? You better be thinking of croup! Join us on this resident-led episode today.

This episode was written by pediatric resident Anjali Doshi and pediatricians Lidia Park and Tammy Yau with content support from Alexis Toney (UC Davis pediatric hospitalist). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

• Croup, acute laryngotracheitis, a viral infection causing respiratory inflammation, bark like cough, and inspiratory stridor
• Westley score can be used to determine severity of croup
• Treatment for mild symptoms is humidified air and supportive care
• Treatment for moderate/severe symptoms is racemic epinephrine breathing treatment and IV dexamethasone
• Imaging can be considered to rule out bacterial tracheitis or epiglottitis if history and physical exam cannot narrow down the differential to croup
• Antibacterials not normally given unless concurrent infection



Reference:

• AAP Point of Care Quick Reference, Retzke, 2021. https://doi.org/10.1542/aap.ppcqr.396247
• Russell KF, Liang Y, O'Gorman K, Johnson DW, Klassen TP. Glucocorticoids for croup. Cochrane Database Syst Rev. 2011;(1):CD001955. Published 2011 Jan 19. doi:10.1002/14651858.CD001955.pub3
• Cochrane Database Syst Rev. 2018;10:CD006822. Epub 2018 Oct 29.
• Juliette Anderson. “Baby with Croup Stridor Barking Cough Visual & Audio Sound - When to Hospitalize.” YouTube, 14 Apr. 2011, www.youtube.com/watch?v=Qbn1Zw5CTbA. Accessed 3 Oct. 2024.

Don’t miss this “ear”-resistible episode on outer ear infections, also known as otitis externa or swimmer’s ear!

This episode was written by Dr. Tammy Yau and Dr. Lidia Park with content support from Dr. Lena van Der List. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• Think otitis externa when your patient has ear pain, ear drainage, decreased hearing, and swelling or debris in the ear canal.
• Treat otitis externa with otic aminoglycosides (neomycin, polymyxin B, trimethoprim-sulfate) when you have an intact tympanic membrane or fluoroquinolone (ciprofloxacin, ofloxacin) if you can’t visualize the tympanic membrane or there is a perforation

Sources:

Pediatrics in Review 2013, https://doi.org/10.1542/pir.34-3-143