Evaluation of Pediatric Patients with Preexcitation Syndromes

Abstract

In this chapter, the following areas are addressed: (1) history and physical examination (signs and symptoms), (2) noninvasive testing, (3) invasive testing and, (4) indications for evaluation. Emphasis on the evaluation of the pediatric patients with one of the preexcitation syndromes is directed toward age as well as the presence of specific symptoms, both important factors when considering whether noninvasive and/or invasive testing is needed. At the outset of the chapter, the discussion of the presentation of pediatric patients includes general features followed by details of signs and symptoms relative to the age of the child. Together, the history and physical examination are paramount in the evaluation of the pediatric patient because the extent of evaluation virtually always depends on the specific signs and symptoms. Next, the chapter includes discussion of the available noninvasive tests with findings, advantages, and limitations of each relative to the pediatric patient. Invasive testing discussion includes similar but more detailed analysis of invasive electrophysiology studies, and lastly, attention is given to indications for evaluation, that is, to the problems of clinicians when they are confronted with a neonate or infant or older child/adolescent who has the preexcitation syndrome. When is evaluation indicated? If evaluation is indicated, are noninvasive and/or invasive testing necessary?