Pediatric Cardiology Update – 613

Ever wondered if every athlete should get an EKG?  Or if caffeine is really as bad for the heart as you thought?

Today on the podcast, Dr. Mark Knoblauch sits down with pediatric cardiologist Dr. Elizabeth Wang and talks about any other information surrounding pediatric cardiology.

Pediatric Cardiology Update

Dr. Wang is a born and raised Texas girl who did her undergrad at Texas A&M and got her medical degree from The University of North Texas.  She did her pediatric residency and fellowship at UT Houston and is still there today.  

Dr. Wang enjoys Pediatric Cardiology and refers to herself and others in this field as glorified electricians and plumbers.  She is particularly interested in the athletic population because of the physiologic response to exercise.  

When should an athlete see a pediatric cardiologist?

If there is no family history and the athlete is otherwise healthy and not reporting any symptoms then I educate them to remain hydrated drinking at least ½ their body weight in water per day and more if they are exercising, I encourage them to get 9-11 hours of sleep per night and to eat well including vegetables.

If symptoms are present, (ie deep pressure in chest, dizziness, passing out or palpitations) or symptoms appear or worsen with exertion then I recommend parents seek out a pediatric cardiologist.

Pediatricians and other general practitioners are vital in finding and referring abnormalities.  Good physical examinations along with screening for hypertension and other abnormalities help differentiate who needs a referral to a pediatric cardiologist.

Are there drinks and other substances you recommend athletes avoid to help their hearts?

Dr. Wang absolutely recommends that athletes avoid caffeine, energy drinks, vape pens and other drugs.  “If I go out of business because everyone stopped drinking caffeine and vaping then I am okay with that and I have done my job!”  An otherwise-normal heart can go into arrhythmia with substances found in drugs and/or caffeine, so Dr. Wang recommends all her patients stay away from these and get more sleep. 

What is your response to the thought that every athlete should get an EKG especially since there is a study sighting that Italy requires it?

Dr. Wang explains the particular study stating this is out of a small region in Italy that is very homogenous.  This doesn’t apply to the US which is a large and very diverse population. EKG’s are a valuable tool but it doesn’t catch everything.  There are false positives on EKG’s that can cause immense stress and thousands of dollars of follow up tests that eventually show a healthy heart, and there are normal EKG’s that aren’t followed up with the right questions about symptoms and exertional symptoms that can have a problem.  There are rare abnormalities that don’t show up on a routine EKG and require a very well trained eye on an echocardiogram to diagnose. EKG’s are useful but we need to follow the guidelines for what does and does not require more testing.

If an AT suspects a cardiac issue and is worried about oxygen saturation is it best to check the lips and nail beds for capillary refill? 

Dr. Wang believes that best practice is to check the gums and the tongue instead of the lips and nail beds.  She explains that if an athlete is panicked or worried it can stimulate the parasympathetic nervous system and that can produce the blue lips or decreased capillary refill.  “The gums and the tongue are most indicative of what your central oxygen saturation is.

Are there any closing thoughts you’d like to share?

Please don’t be a stranger.  I love interactions so please get a hold of me if you have any questions.”  You can email Dr. Wang at Elizabeth.W.Wang@uth.tmc.edu

Pediatric Cardiology Update

Posted by Sports Medicine Broadcast on Tuesday, June 11, 2019

Contact us:

Jeremy Jackson

Shawn Readyshawnreadyatc@gmail.com

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Dr. Mark Knoblauchmaknobla@Central.UH.EDU

Dr. Layci Harrisonlharris5@Central.UH.EDU

Bob MarleyBob.Marley@uth.tmc.edu

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