Sudden cardiac death or SCD is the leading cause of death in athletes and remains one of the most devastating medical events in sports. Though the condition is rare, occurring in only 2 out of 100,000 children each year, it is the leading cause of death in young athletes. SCD may be due to a genetic predisposition or undiagnosed congenital heart disease, heart arrhythmia or abnormalities in the coronary arteries. Pediatricians recommend that every child have an annual physical prior to participating in strenuous exercise or competitive sports. If any heart irregularities are detected, a pediatric cardiologist should be consulted for an electrocardiogram (EKG) or an Echocardiogram, which uses sonar to diagnose congenital heart problems. Daphne Hsu, MD, Chief of Pediatric Cardiology at The Children’s Hospital at Montefiore, has been an advocate for increased cardiac testing of young athletes to prevent sudden cardiac death on the playing fields.
-Daphne Hsu, MD, Chief of Pediatric Cardiology, The Children’s Hospital at Montefiore
CardioGenetics
Montefiore Einstein Center for CardioGenetics offers screening, counseling and treatment to patients who may be at risk for inherited diseases that can trigger Sudden Cardiac Death, as well as other genetic diseases that cause arrhythmias. In fact, about 30% of sudden cardiac death is caused by a single defective gene, which causes a disruption of the electrical system of the heart. The program is directed by cardiologist Christine Walsh, MD and geneticist Robert Marion, MD, of The Children’s Hospital at Montefiore, one of only a handful of programs in the world studying the hereditary markers that can cause sudden cardiac death.
-Christine Walsh, MD, and Robert Marion, MD, Co-Directors of the Montefiore-Einstein Center for CardioGenetics
Living with a Heart Murmur
Heart Murmurs – an extra or unusual sound heard during a heartbeat—are extremely common findings in infants and children. About 95 percent of heart murmurs are “innocent” and have no effect on a child’s health. About 5% are abnormal murmurs resulting from congenital heart defects or heart muscle functional problems. Doctors can detect a murmur through a stethoscope and based on that evaluation can determine if the murmur is abnormal or innocent. If innocent, the child can be as active as other children. If the murmur is abnormal the child should be evaluated by a pediatric cardiologist. The Montefiore Einstein Pediatric Heart Center at The Children’s Hospital at Montefiore, recognized as one of the best children’s hospitals in America, has the ability to diagnose and treat any acquired or congenital children’s heart abnormality.
-Leo Lopez, MD, Director of Non-Invasive Imaging, Pediatric Cardiology, The Children’s Hospital at Montefiore
Automated External Defibrillators: A Matter of Life or Death
An Automated External Defibrillator (AED) is a lifesaving tool that every school teacher and coach should have access to in case of an emergency. If a child suffers a life threatening arrhythmia or cardiac arrest during school or on the playing field, the mobile technology can help shock the heart muscle to restore a normal heart beat. It is important to check if your school and child’s coach have access to an AED and are trained to use it to treat your child in case they suffer a cardiac event. Several states have laws about AEDs in school. New York State, for example, requires schools to have access to an AED. The technology is even required to be present at extracurricular activities at schools and at athletic events on and off school grounds in New York.
-Daphne Hsu, MD, Chief of Pediatric Cardiology, The Children’s Hospital at Montefiore
Pediatric CPR
Cardiopulmonary resuscitation (CPR) is a combination of rescue breathing and chest compressions delivered to victims thought to be in cardiac arrest. Would you know how to perform Cardiopulmonary Resuscitation on a child or infant if it was necessary? Cardiac arrest due to heart failure in a child rarely happens but is more likely due to an injury such as poisoning, smoke inhalation, or head trauma, which causes the breathing to stop first. The brain may sustain damage after blood flow has been stopped for about four minutes and irreversible damage after about seven minutes. How can you tell if a child’s airway is blocked or if they are experiencing cardiac distress? What are the different types of cardiac disturbances and what should you know to properly respond? What techniques should be used to for each age group? The Children’s Hospital at Montefiore works with the American Red Cross and the NYC Fire Department to encourage parents to take Pediatric CPR courses.
-Scott Ceresnak, MD, Pediatric Cardiologist, The Children’s Hospital at Montefiore
Transition from Summer to a Back-to-School Sleep Schedule
Typically, during the summer, children go to bed later and wake up at different times, because they do not have to follow a school schedule. Shelby Harris, Psy.D., C.BSM, Director of the Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center, can discuss how a child can adjust his/her sleep schedule to once again become acclimated to getting up earlier for school. Dr. Harris can provide advice on how kids can start school well-rested and establish a consistent sleep schedule which can help optimize learning. Her pointers include:
- Maintain a steady sleep-wake schedule 7 days a week. No catching up on the weekends!
- Have a regular and relaxing bedtime routine to wind down the hour before bedtime.
- Make sure each step of the bedtime routine slowly moves closer and closer to the bed (e.g. bath, brush teeth, then into bedroom for PJs, book and finally bed).
- Get back on a good, healthy diet overall. Oftentimes, kids’ diets will change over the summer. Limit sugar, chocolate, soda – especially from lunch afterwards.
- Limit electronics and schoolwork within an hour of bedtime (and don’t allow them during the night, either!)
Shelby Harris, Psy.D., C.BSM, Director, Behavioral Sleep Medicine Program at the Sleep-Wake Disorders Center, Montefiore Medical Center and Assistant Professor of Neurology/Psychiatry, Albert Einstein College of Medicine
Easing a Child’s Back-to-School Anxiety
Children as well as teens are often anxious about going back to school. Anxiety can be a result of a transition from elementary to middle school, or challenges socially or academically. Mental health professionals at the Montefiore School Health Program observe many of these issues first-hand and are highly qualified to comment on a wide variety of back-to-school psychological issues. The Montefiore School Health Program, the largest of its kind in the U.S., offers a wide range of medical, dental, mental and community-based services to students and their families in elementary, middle and high schools throughout the Bronx. Since its inception more than 25 years ago, this essential program has steadily grown to 18 full-service centers throughout the borough.
Christine Cheng, Ph.D., Psychology Training Coordinator, licensed clinical psychologist, Montefiore School Health Program, and Instructor of Pediatrics, Albert Einstein College of Medicine. Dr. Cheng helps children cope with various difficulties, such as anxiety, depression, trauma, bereavement and loss, impulse control, and adjustment issues, and she enjoys seeing children overcome them and blossom in their natural social milieu.
Igda Martínez, Psy.D., clinical psychologist, Montefiore School Health Program and Instructor of Pediatrics, Albert Einstein College of Medicine.Dr. Martinez provides bilingual mental health services to elementary school children and their families. She works with children suffering from various adjustment, mood and behavioral disorder
Bullying: What if Your Child is Being Bullied, or is a Bully?
Bullying can impact the wellbeing of children and young people and have serious long-term consequences. It can undermine educational attainment and self-esteem and can destroy a sense of security. The most common forms of bullying reported by children are being verbally bullied, followed by exclusion and physical bullying. Parents and schools also need to be aware that cyber-bullying is affecting younger age groups as more children get mobile phones and have computer access.
Over the past four years, the Montefiore School Health Program mental health division has developed a curriculum called S.T.A.R., Strengthening Tween and Adolescent Relationships. This is an eight-week classroom based program designed to foster healthy relationships between students and reduce teen dating violence. S.T.A.R. was created by Cheryl Hurst, a Senior Social Worker at PS/MS 95 in the Bronx, one of 18 schools that make up the Montefiore School Health program, to teach 12 to 14 year olds how to develop healthy friendships and communicate in nonviolent and supportive ways. Ms. Hurst identified such a huge need, learning about the problems these kids face: cyber-bullying, financial pressures on parents who have lost jobs, poor parental support and more.
Cheryl Hurst, LCSW, Senior Social Worker, Montefiore School Health Program. Ms. Hurst provides individual mental health counseling using therapeutic modalities to help children and adolescents cope with family, academic and environmental stressors.
The Best School Lunch is Delicious and Energizing
Whether packed in a brown bag or served on a cafeteria tray, a nutritious school lunch that’s tasty and satisfying is a welcome midday break for kids and gives them energy to get through the rest of the day. Clinical dietitian Lauren Graf, MS, RD, has tips for parents and kids as they gear up for another school year, from packing a colorful lunch with fresh fruits and vegetables to spotting healthy choices on the cafeteria line. Even for the pickiest of eaters, parents can find the right nutritional balance for their kids and help them adopt good eating habits that can last a lifetime.
Lauren Graf, MS, RD, The Children’s Hospital at Montefiore, is a specialist in general pediatric nutrition, with a subspecialty in renal, heart and healthy cooking for pediatric patients.
Does your Child Need Eyeglasses? Now is the Best Time for Pediatric Eye Exams
The start of a new school season is the best time to have your child’s eyes examined. Pediatric ophthalmologist Norman Medow, MD, can discuss the signs that a child may be having vision problems. Some are obvious, such as sitting close to the TV or holding toys close to the eyes. Squinting to see at a distance, covering or closing one eye to see, may also indicate a need for glasses. Dr. Medow reminds parents that many eye disorders are inherited, especially a need for glasses. If Mom or Dad wore glasses at an early age, it would not be unusual for their child to need glasses as well.
Norman Medow, MD, Chief of Pediatric Ophthalmology at Montefiore Medical Center is an expert in glaucoma, cataract and corneal disorders in children.
Teaching Kids about Healthcare – Radiology Goes Back to School
Kids can play an active role in their own health and safety. To help teach them how to do this, Dr. Scheinfeld has created an interactive radiology teaching kit which consists of a variety of images of bones, as well as orthopantograms of teeth and ultrasound images of fetuses, allowing doctors to speak about various disciplines within healthcare and educate children about radiology as well as broader topics, such as oral hygiene. Dr. Scheinfeld uses the kit to teach kids about the human body, provide important safety advice and also encourage children not to fear the hospital environment. A video of Dr. Scheinfeld teaching kids with the kit can be found here.
Meir Scheinfeld, MD, PhD, Attending Physician, Division Head of Emergency Radiology, Department of Radiology at Montefiore Medical Center can discuss the role of radiology in healthcare and the importance of teaching children about their health from an early age.
