Question of the Week 567

{“questions”:{“d6y3g”:{“id”:”d6y3g”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Kaitlin M. Flannery, MD, MPH – Stanford University \r\n\r\nA 16-year-old, 70 kg patient with a history of orthotopic heart transplantation for dilated cardiomyopathy presents with acute rejection secondary to medication noncompliance. During hospitalization, the patient is noted to have intermittent high-grade second-degree atrioventricular block (AV block), particularly during sleep. Permanent pacemaker implantation is recommended, […]

Question of the Week 566

{“questions”:{“v59jm”:{“id”:”v59jm”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Authors: Megan Quinn, MD, MPH – Stanford University AND Kaitlin M. Flannery, MD, MPH – Stanford University \r\nFollowing aortic arch reconstruction, a 2-month-old continues to experience multisystemic lymphatic failure characterized by high-volume chylous chest tube output, anasarca, and refractory respiratory failure. Maximum medical treatment has been unsuccessful. Dynamic contrast magnetic resonance lymphangiography (DCMRL) revealed thoracic […]

Question of the Week 565

{“questions”:{“cx6rg”:{“id”:”cx6rg”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Authors: Kaitlin M. Flannery, MD, MPH – Stanford University AND Aidan E. Tait, MD – Stanford University \r\n\r\nA full-term, 3.3kg, neonate with hypoplastic left heart syndrome (HLHS) underwent hybrid palliation (bilateral pulmonary artery bands [PABs] and patent ductus arteriosus [PDA] stenting) at day-of-life 3. Hybrid palliation was selected due to a severely hypoplastic ascending aorta […]

Question of the Week 564

{“questions”:{“itqxq”:{“id”:”itqxq”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Authors: Kate Holmes, MSN, RN, CPNP-AC – Lucile Packard Children\u2019s Hospital, Stanford Medicine, Children\u2019s Health AND Kaitlin M. Flannery, MD, MPH – Stanford University \r\nAn 18-month-old with history of Kawaski Disease (KD) at 4-months old, resulting in a giant coronary artery aneurysm (CAA) of the right coronary artery (RCA), currently managed on aspirin and warfarin, […]

Question of the Week 563

{“questions”:{“axxfm”:{“id”:”axxfm”,”mediaType”:”image”,”answerType”:”text”,”imageCredit”:””,”image”:””,”imageId”:””,”video”:””,”imagePlaceholder”:””,”imagePlaceholderId”:””,”title”:”Author: Kanwarpal S. Bakshi, MD \u2013 Children\u2019s Hospital Los Angeles \r\n\r\nA 3-year-old child with hypoplastic left heart syndrome (HLHS) develops a persistent high-output chylothorax several weeks after extra-cardiac non-fenestrated (ECNF) Fontan completion. Despite aggressive medical therapy, the effusions persist. Dynamic contrast MR lymphangiography shows abnormal and diffuse lymphatic congestion around the lung parenchyma without a […]