Pediatric Pulmonary Hypertension: Diagnosis And Management In The Acute Care Setting

Oishi, Peter E. MD
Fineman, Jeffrey R. MD
Hoey, Dolores MD
Sharieff, Ghazala Q. MD, FAAP, FACEP, FAAEM

¹Authors
²Assistant Professor of Pediatrics, Division of Critical Care Medicine, University of California San Francisco, San Francisco, CA
³Professor of Pediatrics, Division of Critical Care Medicine, Investigator, Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA
⁴Peer Reviewers
⁵Attending Physician, Emergency Medicine Department, Our Lady of Lourdes Medical Center, Camden, NJ
⁶Associate Clinical Professor, Children's Hospital and Health Center/University of California, San Diego; Director of Pediatric Emergency Medicine, California Emergency Physicians, San Diego, CA

Date of original release: January 1, 2008

Date of most recent review: December 1, 2007

Termination date: January 1, 2011

Time to complete activity: 4 hours

Medium: Print & online

Method of participation: Print or online answer form and evaluation

Prior to beginning this activity, see “Physician CME Information” on back page.

Pediatric Emergency Medicine Practice 5(1):p 1-22, January 2008.

A 10-year-old girl is brought to the pediatric emergency department after collapsing at school during her physical education class. She is well known to the emergency physicians, having been treated in the ED on multiple occasions over the past year for asthma exacerbations. Most recently, she was admitted for inpatient treatment and was discharged after 24 hours with nebulized bronchodilators.

As the paramedics transfer her to the ED staff, the patient's mother reports that her daughter has experienced increasing shortness of breath with exercise over the past few days - even with walking up stairs at home - and, in general, has appeared to be fatigued. The patient has been using her prescribed inhaler frequently, without clear relief. The mother also mentions that on the evening prior to this event, her daughter complained of abdominal pain.