Mount Sinai – Division of Pediatric Cardiology


Numerous regularly scheduled pediatric cardiology conferences are held, including
didactic clinical and basic science conferences, journal review, pathology
conference, research conference, and clinical conferences on echocardiography,
cardiac catheterization, electrophysiology, patient management, pediatric
cardiology morbidity and mortality, and pediatric cardiology/cardiothoracic
surgical case management.

The didactic conferences are held one to two times per week and are
mandatory for the fellows. The curriculum is divided between clinical
pediatric cardiology and basic science and rotated over a two-year
period. The fellows review individual cardiac lesions using the Nadas
textbook on pediatric cardiology as the starting point. These reviews
include the pathophysiology, presentation, and diagnostic and therapeutic
management of each disorder. Other subjects are covered by lectures
given by the pediatric cardiology faculty, the pediatric cardiology
fellows, and invited speakers from other divisions and departments
at Mount Sinai School of Medicine. The clinical cardiology curriculum
includes congenital heart defects, various forms of acquired heart
disease, surgical and anesthesiology topics, and a host of topics
related to pediatric cardiology, such as the genetics of congenital
heart disease and pregnancy in women with congenital heart disease.
The basic science curriculum draws from diverse topics relevant to
pediatric cardiology, such as ventricular function/physiology, embryology
of the cardiovascular system, molecular biology, pharmacology of cardiovascular
medications, altitude physiology, and radiation biology.

Journal review is held monthly. Each fellow is assigned three different
journals to review from the preceding month. The fellows present one
or two important articles in summary fashion. All the major cardiology
and pediatrics journals are covered each month. This journal review
is also attended by other pediatric cardiology faculty members.

Pathology conferences are held monthly. Sessions are devoted to related
lesions such as atrioventricular canal defects or left heart obstructive
lesions, and they are timed to coincide with the clinical didactic sessions
when possible. Alternatively, recent autopsy cases or cardiac transplant
explants are reviewed. The pediatric cardiology fellows present synopses
of the patient histories and germane clinical studies. The Mount Sinai
pediatric pathologist, demonstrates the anatomy of the heart. When relevant,
kodachrome slides revealing important histologic findings from the heart
and other organs are shown.

The pediatric cardiology research conference is held every three to
four months. Two or three pediatric cardiology faculty and/or fellows
present proposed or ongoing research studies. Substantial discussion
time is provided in order to foster constructive criticism of the research.
These conferences also provide a forum for fellows and faculty to practice
their oral presentations prior to national or regional meetings.

The clinical conferences include echocardiography and cardiothoracic
surgical conferences, held weekly, cardiac catheterization and electrophysiology
conferences, held twice monthly, and patient care conferences, held
thrice weekly.

The echocardiography conference topics range from basic echocardiography
to echocardiography of particular cardiac lesions to recent interesting
cases. Relevant technical topics, such as transducer selection and manipulating
the Doppler filters, are also discussed.

The cardiac catheterization conference reviews basic hemodynamics,
catheterization calculations, and the interpretation of angiography.
Recent and unknown cases are reviewed with the fellows for teaching

The pediatric cardiology/cardiothoracic surgical case presentation
conference is a joint conference between the Division of Pediatric
Cardiology and the Department of Cardiothoracic
with contributions from the Cardiovascular
(Adult Cardiology). Faculty and fellows from these three
groups are present along with invited pediatric cardiologists from other
institutions. The pediatric cardiology fellow on the Cardiac Catheterization
rotation organizes the conference and presents the patients. Pediatric
and adult patients with congenital heart disease and pediatric patients
with acquired heart disease undergoing cardiothoracic procedures the
following week are presented along with cases with difficult management
issues. The patient’s history, physical examination, ECG, echocardiogram,
and cardiac catheterization data are presented, followed by a robust
discussion of the therapeutic options. When relevant, presentations
and discussions include the use of MRI and CT imaging, as well as nuclear
medicine, in evaluating cardiac lesions. Faculty from Radiology, Nuclear
Medicine, and Nuclear Cardiology attend the conference in order to interpret
studies and to discuss technical feasibility and limitations. After
decisions are reached on a therapeutic intervention, potential difficulties
and contingency plans are discussed for each planned procedure.

The curriculum for the electrophysiology conference includes basic
interpretation of pediatric ECG and interpretation of electrophysiologic
studies, as well as diagnostic and therapeutic approaches to electrophysiologic
abnormalities in fetuses, infants, and children. Interesting recent
ECG, EPS, and Holter studies are reviewed with the fellows.

Patient management conference is held three times weekly and is led
by the fellow on the inservice rotation. All inpatients and new consultations
are reviewed with the faculty and fellows. Ongoing clinical problems
and therapeutic plans are discussed. Attendance of these conferences
by a pediatric cardiology nurse clinician, social worker(s), and child
life specialist also provides input on related social and psychosocial
issues impacting pediatric cardiac patients and their families. When
relevant, issues concerning ethical and medical-legal aspects of pediatric
cardiology care are also discussed.

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