{ "name": "HeartCalc", "description": "Pediatric cardiology and neonatal hemodynamics calculators and references for clinicians: cath hemodynamics, congenital heart surgery risk (STAT 2020), HCM sudden cardiac death risk, neonatal blood pressure, bedside guideline references (athlete pre-participation screening, pediatric ICD indications), and experimental prototypes for ICU, echo, neonatal, fetal, ECG and clinic use.", "version": "1.0.0", "generated": "2026-11-02", "homepage": "https://heartcalc.doctorarichai.com/", "author": { "name": "Piyawat Arichai, MD, FAAP", "url": "https://doctorarichai.com" }, "privacy": "Every HeartCalc page computes in the browser: nothing entered into a calculator is stored or sent anywhere. The optional \"Report a problem\" form sends only what is typed into it, the page and the section; calculator inputs are never included. A prefill link carries its values in the URL; values after ? reach the web host's request logs like any URL, values after # stay in the browser. Never put identifiers in a link.", "openapi": "https://heartcalc.doctorarichai.com/openapi.json", "llms": "https://heartcalc.doctorarichai.com/llms.txt", "llms_full": "https://heartcalc.doctorarichai.com/llms-full.txt", "usage_rules": [ "Cite the source: name the model or reference the tool uses (its sources list) next to any number you report.", "Report guard and not-applicable messages as the tool states them (for example \"No model applies under 1 year of age\"); never compute around a guard or extrapolate beyond a stated population.", "Label experimental tools as \"experimental prototype, not independently verified\" wherever you use them.", "Decision support only: results inform a clinician; they are not a diagnosis, an order or a treatment decision.", "Never send identifiers. No names, record numbers, dates of birth, exact dates of service, addresses or free text about a patient in API calls or links. Use age (ageY) rather than a date of birth.", "Hand off with a prefill link so the clinician sees the page, its notices and its sources, and checks every value against the patient." ], "prefill": { "pattern": "?=&...", "rules": [ "Pattern: ?=&=... Input names are the form control ids and radio-group names listed in each tool's inputs.", "Radio groups and selects take an option value (case-insensitive; an option label also works). Checkboxes take 1, true, yes or on (0, false, no or off to clear). Dates take YYYY-MM-DD. Numbers use a dot for decimals.", "Mode-setting radios are applied first, then everything else, so the page shows the right fields.", "The page shows a caution notice, \"Filled from a link.\", listing every field it set, asking the clinician to check each value against the patient, and listing parameters it ignored or found invalid. Unknown parameters fill nothing.", "Query-string values reach the web host's request logs like any URL. The same parameters after # instead of ? never leave the browser." ] }, "statuses": { "verified": "Checked against its primary references; listed in the site navigation.", "experimental": "Experimental prototype, not independently verified. Do not use for clinical decisions; check results against the primary references." }, "tools": [ { "id": "cath", "name": "Cath Hemodynamics", "url": "https://heartcalc.doctorarichai.com/cath", "status": "verified", "group": "cath", "group_label": "Cath & Surgery", "description": "Fick flows and resistances from cath saturations and pressures.", "keywords": "fick qp qs qp:qs pvr svr pvri svri vo2 lafarge lundell seckeler saturation resistance shunt catheterization", "population": "Children and adults with congenital or acquired heart disease having cardiac catheterization with oximetry and pressures (steady state). Predicted VO2: Seckeler for all ages (derived at 0 to 59 years, adjusts for single ventricle and ICU status); Lundell for any age (separate equations under and from 3 years); LaFarge only from 3 years. Dissolved oxygen is ignored, so results are less accurate on supplemental oxygen.", "method_url": "https://heartcalc.doctorarichai.com/cath#method", "inputs": [ { "name": "dob", "label": "Date of birth", "type": "date", "unit": null, "required": false, "notes": "YYYY-MM-DD. With cathDate, replaces the typed age. Avoid in links: a date of birth is an identifier." }, { "name": "cathDate", "label": "Cath date", "type": "date", "unit": null, "required": false, "notes": "YYYY-MM-DD. Defaults to today." }, { "name": "ageY", "label": "Age, years", "type": "number", "unit": "years", "min": 0, "required": false, "notes": null }, { "name": "ageM", "label": "Age, plus months", "type": "number", "unit": "months", "min": 0, "required": false, "notes": null }, { "name": "ageD", "label": "Age, plus days", "type": "number", "unit": "days", "min": 0, "required": false, "notes": "Hint: for neonates." }, { "name": "sex", "label": "Sex", "type": "select", "unit": null, "options": [ { "value": "M", "label": "Male" }, { "value": "F", "label": "Female" } ], "required": false, "notes": "Used by Lundell (3 y and older) and LaFarge." }, { "name": "ht", "label": "Height", "type": "number", "unit": "cm", "required": false, "notes": null }, { "name": "wt", "label": "Weight", "type": "number", "unit": "kg", "required": false, "notes": null }, { "name": "bsaOv", "label": "BSA override", "type": "number", "unit": "m²", "required": false, "notes": "Optional." }, { "name": "hgb", "label": "Hemoglobin", "type": "number", "unit": "g/dL", "required": false, "notes": null }, { "name": "vo2Method", "label": "VO₂ source", "type": "select", "unit": null, "options": [ { "value": "seckeler", "label": "Predicted: Seckeler (all ages, adjusts for SV and ICU)" }, { "value": "auto", "label": "Predicted: Lundell under 3 y, LaFarge from 3 y" }, { "value": "lundell", "label": "Predicted: Lundell (any age)" }, { "value": "lafarge", "label": "Predicted: LaFarge (3 y and older)" }, { "value": "manual", "label": "Enter my own index" } ], "default": "seckeler", "required": false, "notes": "manual uses vo2i." }, { "name": "sv", "label": "Single ventricle anatomy", "type": "checkbox", "unit": null, "required": false, "notes": "Seckeler: −9.6 mL/min/m². Seckeler term only." }, { "name": "ci", "label": "Critically ill (ICU patient)", "type": "checkbox", "unit": null, "required": false, "notes": "Seckeler: −11.2 mL/min/m². Seckeler term only." }, { "name": "hr", "label": "Heart rate", "type": "number", "unit": "bpm", "required": false, "notes": "Used by Lundell and LaFarge only." }, { "name": "vo2i", "label": "VO₂ index", "type": "number", "unit": "mL/min/m²", "required": false, "notes": "Used only when vo2Method is manual." }, { "name": "vo2abs", "label": "Measured VO₂", "type": "number", "unit": "mL/min", "required": false, "notes": "Optional. Measured VO2; overrides any predicted or manual index." }, { "name": "sao2", "label": "Systemic arterial saturation", "type": "number", "unit": "%", "required": true, "notes": null }, { "name": "mvDirect", "label": "Mixed venous saturation", "type": "number", "unit": "%", "required": true, "notes": null }, { "name": "pa", "label": "Pulmonary artery saturation", "type": "number", "unit": "%", "required": true, "notes": null }, { "name": "pv", "label": "Pulmonary vein saturation", "type": "number", "unit": "%", "required": false, "notes": "98 if blank." }, { "name": "mAo", "label": "Mean aortic pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "mRA", "label": "Mean right atrial pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "mPA", "label": "Mean pulmonary artery pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "mLA", "label": "Mean left atrial pressure or PCWP", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "diffOn", "label": "Correct for unequal right and left lung flow", "type": "checkbox", "unit": null, "required": false, "notes": "Use with a lung perfusion scan or MRI flow split, branch PA stenosis, or unilateral pulmonary vein disease. Turns on the differential lung perfusion fields (pctR, mRPA, mLPA, rpv, lpv)." }, { "name": "pctR", "label": "Right lung flow", "type": "number", "unit": "%", "min": 0, "max": 100, "required": false, "notes": "Used only when diffOn is set. Left lung flow = 100 minus this." }, { "name": "mRPA", "label": "Mean RPA", "type": "number", "unit": "mmHg", "required": false, "notes": "Main PA if blank. Used only when diffOn is set." }, { "name": "mLPA", "label": "Mean LPA", "type": "number", "unit": "mmHg", "required": false, "notes": "Main PA if blank. Used only when diffOn is set." }, { "name": "rpv", "label": "Right pulm. vein", "type": "number", "unit": "%", "required": false, "notes": "PV sat if blank. Used only when diffOn is set." }, { "name": "lpv", "label": "Left pulm. vein", "type": "number", "unit": "%", "required": false, "notes": "PV sat if blank. Used only when diffOn is set." } ], "input_notes": "Qp:Qs needs only sao2, mvDirect and pa (pv defaults to 98% and is marked as assumed). Flows and resistances also need hgb, a BSA (ht and wt, or bsaOv), mean pressures, and a VO2: vo2abs (measured, overrides everything), vo2Method=manual with vo2i, or a predicted equation (Seckeler needs age and wt; Lundell needs ht, wt and hr under 3 y, or sex and hr from 3 y; LaFarge needs sex and hr, from 3 y). Age is ageY plus ageM plus ageD, or dob with cathDate. Prefer ageY/ageM/ageD in links: dates of birth are identifiers.", "outputs": [ "Qp:Qs", "Qs, Qp and effective pulmonary flow (L/min and L/min/m2)", "PVR, PVRi, SVR, SVRi (WU and WU.m2) and Rp:Rs", "Transpulmonary gradient", "Predicted VO2 by Seckeler, Lundell and LaFarge, with the one used", "Flows and resistances if predicted VO2 is off by 1 SD", "Per-lung flow and PVRi with differential lung perfusion" ], "sources": [ { "citation": "Lundell BP, Casas ML, Wallgren CG. Oxygen consumption in infants and children during heart catheterization. Pediatr Cardiol 1996;17(4):207-213.", "doi": "10.1007/BF02524795" }, { "citation": "Seckeler MD, Hirsch R, Beekman RH 3rd, Goldstein BH. A new predictive equation for oxygen consumption in children and adults with congenital and acquired heart disease. Heart 2015;101(7):517-524.", "doi": "10.1136/heartjnl-2014-306378" }, { "citation": "Laitinen PO, Räsänen J. Measured versus predicted oxygen consumption in children with congenital heart disease. Heart 1998;80(6):601-605.", "doi": "10.1136/hrt.80.6.601" }, { "citation": "LaFarge CG, Miettinen OS. The estimation of oxygen consumption. Cardiovasc Res 1970;4(1):23-30.", "doi": "10.1093/cvr/4.1.23" } ], "prefill_example": "https://heartcalc.doctorarichai.com/cath?ageY=0&ageM=6&sex=M&ht=68&wt=7.5&hgb=11.5&vo2Method=seckeler&hr=140&sao2=97&mvDirect=71&pa=85&mAo=55&mRA=6&mPA=28&mLA=8", "api": "https://heartcalc.doctorarichai.com/api/v1/cath" }, { "id": "stat", "name": "Surgical Mortality Risk", "url": "https://stat.doctorarichai.com", "status": "verified", "group": "cath", "group_label": "Cath & Surgery", "external": true, "description": "STAT Score, Category and model-based operative mortality for congenital heart surgery procedures.", "sources": [ { "citation": "Jacobs ML, Jacobs JP, Thibault D, et al. Updating an Empirically Based Tool for Analyzing Congenital Heart Surgery Mortality (STAT 2020 Mortality Score and Categories). World J Pediatr Congenit Heart Surg 2021;12(2):246-281.", "doi": "10.1177/2150135121991528" } ] }, { "id": "scd", "name": "Sudden Cardiac Death Risk (HCM)", "url": "https://heartcalc.doctorarichai.com/scd", "status": "verified", "group": "clinic", "group_label": "Clinic", "description": "5-year risk of sudden cardiac death in hypertrophic cardiomyopathy, with the model chosen by age.", "keywords": "hcm hypertrophic cardiomyopathy sudden death scd icd risk-kids risk-scd aha esc primacy", "population": "Patients with hypertrophic cardiomyopathy, for primary prevention at the first (baseline) evaluation. Age chooses the model (completed years): 1 to 15, HCM Risk-Kids; 16, both; 17 to 80, HCM Risk-SCD (adult). No model under 1 year or over 80. Not applicable after prior VF, sustained VT, resuscitated arrest or appropriate ICD shock (secondary prevention), or with a syndromic, metabolic or neuromuscular cause; HCM Risk-Kids excludes HCM diagnosed before 1 year; HCM Risk-SCD is not for elite or competitive athletes, and needs caution after myectomy or alcohol septal ablation.", "method_url": "https://heartcalc.doctorarichai.com/scd#method", "inputs": [ { "name": "dob", "label": "Date of birth", "type": "date", "unit": null, "required": false, "notes": "YYYY-MM-DD. With evalDate, replaces ageY. Avoid in links: a date of birth is an identifier." }, { "name": "evalDate", "label": "Evaluation date", "type": "date", "unit": null, "required": false, "notes": "YYYY-MM-DD. Defaults to today." }, { "name": "ageY", "label": "Age", "type": "number", "unit": "years", "min": 0, "required": true, "notes": "Completed years choose the model." }, { "name": "sex", "label": "Sex", "type": "select", "unit": null, "options": [ { "value": "male", "label": "Male" }, { "value": "female", "label": "Female" } ], "required": false, "notes": "HCM Risk-Kids measurement mode only." }, { "name": "wt", "label": "Weight", "type": "number", "unit": "kg", "required": false, "notes": "HCM Risk-Kids measurement mode only (BSA = 0.1023 x weight^0.68)." }, { "name": "priorArrest", "label": "Prior VF, sustained VT, resuscitated cardiac arrest or appropriate ICD shock", "type": "checkbox", "unit": null, "required": false, "notes": "Secondary prevention. Both models are for primary prevention only." }, { "name": "infantOnset", "label": "HCM diagnosed before 1 year of age", "type": "checkbox", "unit": null, "required": false, "notes": "Infant-onset HCM was excluded from HCM Risk-Kids development." }, { "name": "syndromic", "label": "Syndromic, metabolic or neuromuscular cause", "type": "checkbox", "unit": null, "required": false, "notes": "For example RASopathy (Noonan), Pompe, Anderson–Fabry or other inborn errors of metabolism, Friedreich ataxia. Neither model applies." }, { "name": "athlete", "label": "Elite or competitive athlete", "type": "checkbox", "unit": null, "required": false, "notes": "HCM Risk-SCD is not for use in elite or competitive athletes." }, { "name": "septal", "label": "Prior myectomy or alcohol septal ablation", "type": "checkbox", "unit": null, "required": false, "notes": "Caution should be exercised when assessing SCD risk after invasive LVOT gradient reduction (AHA calculator)." }, { "name": "mode", "label": "HCM Risk-Kids input", "type": "radio", "unit": null, "options": [ { "value": "mm", "label": "Measurements (mm)" }, { "value": "z", "label": "I have Z scores" } ], "default": "mm", "required": false, "notes": "mm (default) uses mwtMm and laMm; z uses mwtZ and laZ." }, { "name": "mwtMm", "label": "Maximal LV wall thickness", "type": "number", "unit": "mm", "required": true, "notes": null }, { "name": "laMm", "label": "Left atrial diameter", "type": "number", "unit": "mm", "required": true, "notes": null }, { "name": "mwtZ", "label": "Maximal LV wall thickness Z score (PHN, BSA-adjusted)", "type": "number", "unit": "Z", "required": false, "notes": "Example: 10.8. Used only when mode is z." }, { "name": "laZ", "label": "Left atrial diameter Z score (Neilan)", "type": "number", "unit": "Z", "required": false, "notes": "Example: 0.5. Used only when mode is z." }, { "name": "lvot", "label": "Maximal LVOT gradient", "type": "number", "unit": "mmHg", "min": 0, "required": true, "notes": null }, { "name": "syncope", "label": "Unexplained syncope", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": true, "notes": "Transient loss of consciousness, no identifiable cause." }, { "name": "nsvt", "label": "Non-sustained VT", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": true, "notes": "≥3 beats at ≥120 bpm, <30 s, on ambulatory ECG." }, { "name": "fh", "label": "Family history of SCD (HCM Risk-SCD definition)", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": "≥1 first-degree relative under 40 y, or a first-degree relative with confirmed HCM at any age. HCM Risk-SCD (16 and over) only." }, { "name": "fh50", "label": "Family history of HCM-related sudden death", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": "Sudden death judged definitively or likely attributable to HCM in ≥1 first-degree or close relatives who are ≤50 years of age. 2024 AHA/ACC section." }, { "name": "massive", "label": "Massive LVH (child)", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": "No absolute or Z-score threshold is established; a maximal wall thickness corresponding to a Z score ≥20 (and >10 in conjunction with other risk factors) appears reasonable. 2024 AHA/ACC section, children (under 16) only; adults use wall thickness >= 30 mm." }, { "name": "aneur", "label": "LV apical aneurysm", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": "Discrete thin-walled dyskinetic or akinetic segment with transmural scar or LGE, most distal LV, any size. 2024 AHA/ACC section." }, { "name": "lvef", "label": "LVEF <50%", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": "Systolic dysfunction by echo or CMR. 2024 AHA/ACC section." }, { "name": "lge", "label": "Extensive LGE on CMR", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" }, { "value": "notdone", "label": "Not done" } ], "required": false, "notes": "≥15% of LV mass. 2024 AHA/ACC section." } ], "input_notes": "Age (ageY, or dob with evalDate) chooses the model. HCM Risk-Kids in measurement mode (mode=mm, the default) also needs sex and wt to convert mwtMm and laMm to Z scores; in mode=z it uses mwtZ and laZ (PHN and Neilan references) instead. HCM Risk-SCD (16 and over) needs mwtMm, laMm, lvot, syncope, nsvt and fh. The 2024 AHA/ACC section uses fh50, aneur, lvef and lge, plus massive for children. Prefer ageY in links: dates of birth are identifiers.", "outputs": [ "5-year risk of sudden cardiac death (%) from HCM Risk-Kids and/or HCM Risk-SCD", "Risk group: low (<4%), intermediate (4 to <6%), high (>=6%)", "Calculated MWT and LA Z scores (HCM Risk-Kids, measurement mode)", "2024 AHA/ACC major SCD risk factors and ICD recommendation class", "A not-applicable explanation when no model applies" ], "sources": [ { "citation": "Arbelo E, Protonotarios A, Gimeno JR, et al. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J 2023;44(37):3503-3626.", "doi": "10.1093/eurheartj/ehad194" }, { "citation": "Ommen SR, Ho CY, Asif IM, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy. Circulation 2024;149(23):e1239-e1311.", "doi": "10.1161/CIR.0000000000001250" }, { "citation": "Norrish G, Ding T, Field E, et al. Development of a novel risk prediction model for sudden cardiac death in childhood hypertrophic cardiomyopathy (HCM Risk-Kids). JAMA Cardiol 2019;4(9):918-927. doi:10.1001/jamacardio.2019.2861", "doi": "10.1001/jamacardio.2019.2861" }, { "citation": "Norrish G, et al. External validation of the HCM Risk-Kids model for predicting sudden cardiac death in childhood hypertrophic cardiomyopathy. Eur J Prev Cardiol 2022;29(4):678-686. doi:10.1093/eurjpc/zwab181", "doi": "10.1093/eurjpc/zwab181" }, { "citation": "Norrish G, et al. Relationship between maximal left ventricular wall thickness and sudden cardiac death in childhood onset hypertrophic cardiomyopathy. Circ Arrhythm Electrophysiol 2022;15(5):e010075. doi:10.1161/CIRCEP.121.010075", "doi": "10.1161/CIRCEP.121.010075" }, { "citation": "Lopez L, Colan S, Stylianou M, et al. PHN Normal Echocardiogram Database Z scores. Circ Cardiovasc Imaging 2017;10(11):e006979. doi:10.1161/CIRCIMAGING.117.006979", "doi": "10.1161/CIRCIMAGING.117.006979" }, { "citation": "Neilan TG, Pradhan AD, King ME, Weyman AE. Derivation of a size-independent variable for scaling of cardiac dimensions in a normal paediatric population. Eur J Echocardiogr 2009;10(1):50-55. doi:10.1093/ejechocard/jen110", "doi": "10.1093/ejechocard/jen110" }, { "citation": "Boleti O, Roussos S, Norrish G, et al. Sudden cardiac death in childhood RASopathy-associated hypertrophic cardiomyopathy: validation of the HCM Risk-Kids model. Int J Cardiol 2023;393:131405. doi:10.1016/j.ijcard.2023.131405", "doi": "10.1016/j.ijcard.2023.131405" }, { "citation": "Norrish G, et al. Performance of the PRIMaCY sudden death risk prediction model for childhood hypertrophic cardiomyopathy. Europace 2023;25(11):euad330. doi:10.1093/europace/euad330", "doi": "10.1093/europace/euad330" }, { "citation": "Wilkin, Khraiche, Panaioli, et al. Independent external evaluation of pediatric hypertrophic cardiomyopathy risk scores in predicting severe ventricular arrhythmias. Circ Arrhythm Electrophysiol 2025;18(3):e012932. doi:10.1161/CIRCEP.124.012932", "doi": "10.1161/CIRCEP.124.012932" }, { "citation": "Miron A, Lafreniere-Roula M, Steve Fan CP, et al. A validated model for sudden cardiac death risk prediction in pediatric hypertrophic cardiomyopathy. Circulation 2020;142(3):217-229. doi:10.1161/CIRCULATIONAHA.120.047235", "doi": "10.1161/CIRCULATIONAHA.120.047235" }, { "citation": "O'Mahony C, Jichi F, Pavlou M, et al. A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD). Eur Heart J 2014;35(30):2010-2020. PMID 24126876. doi:10.1093/eurheartj/eht439", "doi": "10.1093/eurheartj/eht439" }, { "citation": "O'Mahony C, Jichi F, Ommen SR, et al. International external validation study of the 2014 European Society of Cardiology guidelines on sudden cardiac death prevention in hypertrophic cardiomyopathy (EVIDENCE-HCM). Circulation 2018;137(10):1015-1023. doi:10.1161/CIRCULATIONAHA.117.030437", "doi": "10.1161/CIRCULATIONAHA.117.030437" }, { "citation": "Elliott PM, Anastasakis A, Borger MA, et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy. Eur Heart J 2014;35(39):2733-2779. doi:10.1093/eurheartj/ehu284", "doi": "10.1093/eurheartj/ehu284" } ], "prefill_example": "https://heartcalc.doctorarichai.com/scd?ageY=12&sex=male&wt=40&mwtMm=17&laMm=29&lvot=24&syncope=no&nsvt=no&fh50=no&massive=no&aneur=no&lvef=no&lge=notdone", "api": "https://heartcalc.doctorarichai.com/api/v1/scd" }, { "id": "neonatal-bp", "name": "Neonatal Blood Pressure", "url": "https://heartcalc.doctorarichai.com/neonatal-bp", "status": "verified", "group": "icu", "group_label": "NICU & CICU", "description": "Systolic BP centile for babies born at 23 to 41 weeks, from birth through the first year (NNNI 1999).", "keywords": "neonatal blood pressure systolic hypotension hypertension preterm centile percentile nnni midas", "population": "Babies born at 23+0 to 41+6 weeks gestation, from birth to 365 days of postnatal age. Systolic pressure only, against a Doppler-measured reference (Northern Neonatal Nursing Initiative 1999) whose centiles are reconstructed from stated values and figures, so they are approximate. Not for diastolic or mean pressure; from 1 year of age use the Pediatric Blood Pressure tool.", "method_url": "https://heartcalc.doctorarichai.com/neonatal-bp#method", "inputs": [ { "name": "gaW", "label": "Gestation at birth, weeks", "type": "number", "unit": "wk", "min": 23, "max": 41, "required": true, "notes": null }, { "name": "gaD", "label": "Gestation at birth, days", "type": "number", "unit": "d", "min": 0, "max": 6, "required": false, "notes": null }, { "name": "mode", "label": "Enter age as", "type": "radio", "unit": null, "options": [ { "value": "pna", "label": "Postnatal days" }, { "value": "pma", "label": "Postmenstrual age" } ], "default": "pna", "required": false, "notes": "pna (default) uses pna; pma uses pmaW and pmaD." }, { "name": "pna", "label": "Postnatal age", "type": "number", "unit": "days", "min": 0, "max": 365, "required": true, "notes": "Day of birth = 0. Fractions allowed (0.5 = 12 hours). Used when mode is pna." }, { "name": "pmaW", "label": "Postmenstrual age, weeks", "type": "number", "unit": "wk", "min": 23, "required": false, "notes": "Used when mode is pma." }, { "name": "pmaD", "label": "Postmenstrual age, days", "type": "number", "unit": "d", "min": 0, "max": 6, "required": false, "notes": "Used when mode is pma." }, { "name": "sbp", "label": "Systolic BP", "type": "number", "unit": "mm Hg", "required": false, "notes": "Optional. Doppler or oscillometric systolic reading." } ], "input_notes": "Gestation at birth is gaW plus gaD. Age is pna (postnatal days, mode=pna, the default) or pmaW plus pmaD (postmenstrual age, mode=pma). Gestation and age give the centiles; add sbp to get its percentile.", "outputs": [ "Percentile and z-score of a systolic reading", "Mean and SD of systolic BP for gestation and age", "3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th centiles (mm Hg), including the MIDAS 75th and 95th thresholds", "Postmenstrual age and phase (first 10 days, rising, stable)", "The paper's first-10-day shortcut and first-day rule where they apply" ], "sources": [ { "citation": "Northern Neonatal Nursing Initiative. Systolic blood pressure in babies of less than 32 weeks gestation in the first year of life. Arch Dis Child Fetal Neonatal Ed 1999;80(1):F38-F42.", "doi": "10.1136/fn.80.1.F38" }, { "citation": "McNamara PJ, Chock VY, Rahde-Bischoff A, et al. Evaluating the efficacy and safety of milrinone for prevention of post-patent ductus arteriosus closure syndrome (the MIDAS trial) in extremely preterm infants. BMJ Open 2025;15(8):e105018.", "doi": "10.1136/bmjopen-2025-105018" } ], "prefill_example": "https://heartcalc.doctorarichai.com/neonatal-bp?gaW=26&gaD=3&mode=pna&pna=5&sbp=46", "api": "https://heartcalc.doctorarichai.com/api/v1/neonatal-bp" }, { "id": "neonatal-echo", "name": "Neonatal Echo Hemodynamics", "url": "https://heartcalc.doctorarichai.com/neonatal-echo", "status": "experimental", "group": "echo", "group_label": "Echo", "description": "Targeted neonatal echo: LV and RV output, SVC flow, the El-Khuffash PDA severity score and the Iowa PDA score, with gestational and postnatal age guards.", "keywords": "tne targeted neonatal echo lvo rvo svc flow pda ductus el-khuffash iowa pda score", "population": "Preterm and term neonates having targeted neonatal echocardiography. Low SVC flow threshold: infants born before 30 weeks in the first 48 hours. El-Khuffash PDA severity score: infants born before 29 weeks, scanned at 24 to 48 hours. Iowa PDA score: preterm infants with a PDA, 12 hours to 40 days. 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Flows need weight with its unit (wunit, no default), heart rate and a diameter plus VTI pair. The PDA scores need gestation (gaW, gaD), postnatal hours and the PDA fields.", "outputs": [ "LV output, RV output and SVC flow (mL/kg/min) with ±10% diameter uncertainty", "Low SVC flow flag (<41 mL/kg/min)", "El-Khuffash PDA severity score", "Iowa PDA shunt-volume score (0 to 14) and category", "Post-ligation LVO <200 mL/kg/min marker", "TAPSE z-score by gestational age for scans in the first 48 h (Koestenberger 2011), with neonatal references" ], "sources": [ { "citation": "Kluckow M, Evans N. Superior vena cava flow in newborn infants: a novel marker of systemic blood flow. Arch Dis Child Fetal Neonatal Ed 2000;82(3):F182-F187.", "doi": "10.1136/fn.82.3.f182" }, { "citation": "Miletin et al. Front Pediatr 2021 (standard Kluckow SVC flow method).", "doi": "10.3389/fped.2021.661698" }, { "citation": "Osborn DA, Evans N, Kluckow M. Arch Dis Child Fetal Neonatal Ed 2004;89(2):F168-F173.", "doi": "10.1136/adc.2002.023796" }, { "citation": "Kluckow M, Evans N. Arch Dis Child Fetal Neonatal Ed 2000;82(3):F188.", "doi": "10.1136/fn.82.3.f188" }, { "citation": "El-Khuffash A, James AT, Corcoran JD, et al. A patent ductus arteriosus severity score predicts chronic lung disease or death before discharge. J Pediatr 2015;167(6):1354-1361.e2. doi:10.1016/j.jpeds.2015.09.028", "doi": "10.1016/j.jpeds.2015.09.028" }, { "citation": "El-Khuffash et al. PDA RCT protocol. HRB Open Res 2021 (El-Khuffash score coefficients).", "doi": "10.12688/hrbopenres.13140.1" }, { "citation": "Mullaly et al. BMJ Paediatr Open 2025 (cohort applying the El-Khuffash score).", "doi": "10.1136/bmjpo-2025-003347" }, { "citation": "Brandt C, Mat HD, Bischoff AR, McNamara PJ, Rios DR. Association of low shunt burden from PDA and adverse outcomes in premature infants. J Perinatol 2026;46(3):364-369.", "doi": "10.1038/s41372-025-02437-4" }, { "citation": "Mifflin J, Makoni M, Chatmethakul T, McNamara PJ, Bischoff AR. Cerebral and intestinal Doppler patterns according to PDA shunt characteristics in preterm infants. J Perinatol 2026;46(3):349-357.", "doi": "10.1038/s41372-025-02505-9" }, { "citation": "Int J Pediatr 2025 (description of the Iowa PDA score items).", "doi": "10.1155/ijpe/5558870" }, { "citation": "Hobson et al. J Pediatr 2025 (Iowa high-volume shunt, score >= 9).", "doi": "10.1016/j.jpeds.2025.114965" }, { "citation": "Battersby et al. Arch Dis Child Fetal Neonatal Ed 2026 (Iowa early-screening programme).", "doi": "10.1136/archdischild-2025-330266" }, { "citation": "Giesinger et al. Semin Perinatol 2023.", "doi": "10.1016/j.semperi.2023.151721" }, { "citation": "Rios DR, de Freitas Martins F, El-Khuffash A, Weisz DE, Giesinger RE, McNamara PJ. Early role of the atrial-level communication in premature infants with patent ductus arteriosus. J Am Soc Echocardiogr 2021;34(4):423-432.e1.", "doi": "10.1016/j.echo.2020.11.008" }, { "citation": "Jain A, Sahni M, El-Khuffash A, et al. Use of targeted neonatal echocardiography to prevent postoperative cardiorespiratory instability after patent ductus arteriosus ligation. J Pediatr 2012;160(4):584-589.e1. doi:10.1016/j.jpeds.2011.09.027", "doi": "10.1016/j.jpeds.2011.09.027" }, { "citation": "Koestenberger M, Nagel B, Ravekes W, et al. Systolic right ventricular function in preterm and term neonates: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 258 patients and calculation of z-score values. Neonatology 2011;100(1):85-92. doi:10.1159/000322006", "doi": "10.1159/000322006" }, { "citation": "Koestenberger M, Ravekes W, Everett AD, et al. Right ventricular function in infants, children and adolescents: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 640 healthy patients and calculation of z score values. J Am Soc Echocardiogr 2009;22(6):715-719. doi:10.1016/j.echo.2009.03.026", "doi": "10.1016/j.echo.2009.03.026" }, { "citation": "Jain A, et al. 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Each reference row states its own population, age, method and source; rows are not interchangeable, and cut-off rows grade disease rather than define normal.", "method_url": "https://heartcalc.doctorarichai.com/neonatal-echo-ref#method", "inputs": [ { "name": "q", "label": "Search", "type": "text", "unit": null, "required": false, "notes": "Example: TAPSE preterm. Filters the reference table by parameter, author or population." }, { "name": "cat", "label": "Category", "type": "select", "unit": null, "options": [ { "value": "all", "label": "All categories" }, { "value": "flow", "label": "Output and flow" }, { "value": "duct", "label": "Ductus and atrial shunt" }, { "value": "rv", "label": "RV and pulmonary pressure" }, { "value": "lv", "label": "LV function and size" }, { "value": "guide", "label": "Guidelines" } ], "required": false, "notes": null }, { "name": "trv", "label": "TR peak velocity", "type": "number", "unit": "m/s", "min": 0, "required": false, "notes": null }, { "name": "rap", "label": "Right atrial pressure", "type": "number", "unit": "mm Hg", "min": 0, "required": false, "notes": null }, { "name": "sbp", "label": "Systolic BP (optional)", "type": "number", "unit": "mm Hg", "min": 0, "required": false, "notes": null } ], "input_notes": "q filters the reference table by text; cat filters by category. trv and rap give RVSP; sbp adds the RVSP:SBP ratio.", "outputs": [ "Searchable table of published neonatal echo reference ranges and cut-offs, each with population, method and citation", "RVSP from the TR jet (4v^2 + RA pressure), and RVSP as a fraction of systolic BP" ], "sources": [ { "citation": "de Boode WP, Singh Y, Molnar Z, et al. Application of Neonatologist Performed Echocardiography in the assessment and management of persistent pulmonary hypertension of the newborn. Pediatr Res 2018;84(Suppl 1):68-77. doi:10.1038/s41390-018-0082-0", "doi": "10.1038/s41390-018-0082-0" }, { "citation": "Kluckow M, Evans N. Arch Dis Child Fetal Neonatal Ed 2000;82:F182-7", "doi": "10.1136/fn.82.3.f182" }, { "citation": "Osborn DA, Evans N, Kluckow M. Arch Dis Child Fetal Neonatal Ed 2004;89:F168-73", "doi": "10.1136/adc.2002.023796" }, { "citation": "de Boode WP, et al. Pediatr Res 2018;84(Suppl 1):57-67 (NPE: neonatal shock)", "doi": "10.1038/s41390-018-0081-1" }, { "citation": "Evans N, Kluckow M. Arch Dis Child Fetal Neonatal Ed 1996;74:F88-94", "doi": "10.1136/fn.74.2.f88" }, { "citation": "Jain A, et al. J Pediatr 2012;160:584-589.e1", "doi": "10.1016/j.jpeds.2011.09.027" }, { "citation": "Groves AM, Kuschel CA, Knight DB, Skinner JR. Pediatr Res 2008;63:89-94", "doi": "10.1203/PDR.0b013e31815b4830" }, { "citation": "van Laere D, et al. Pediatr Res 2018;84(Suppl 1):46-56 (NPE: PDA), Table 2", "doi": "10.1038/s41390-018-0077-x" }, { "citation": "Kluckow M, Evans N. J Pediatr 1995;127:774-9", "doi": "10.1016/s0022-3476(95)70172-9" }, { "citation": "Brandt C, et al. J Perinatol 2026;46:364-369, Table 1", "doi": "10.1038/s41372-025-02437-4" }, { "citation": "Su BH, et al. Arch Dis Child Fetal Neonatal Ed 1997;77:F36-40", "doi": "10.1136/fn.77.1.f36" }, { "citation": "Iyer P, Evans N. Arch Dis Child Fetal Neonatal Ed 1994;70:F112-7", "doi": "10.1136/fn.70.2.f112" }, { "citation": "Lu DF, et al. Front Pediatr 2022;10:894152, Table 12", "doi": "10.3389/fped.2022.894152" }, { "citation": "El-Khuffash A, et al. J Pediatr 2015;167:1354-1361.e2", "doi": "10.1016/j.jpeds.2015.09.028" }, { "citation": "Evans N, Iyer P. J Pediatr 1994;125:778-85; Bischoff AR, et al. Echocardiography 2021;38:1524-33", "doi": "10.1016/s0022-3476(94)70078-8" }, { "citation": "Rios DR, et al. J Am Soc Echocardiogr 2021;34:423-432.e1", "doi": "10.1016/j.echo.2020.11.008" }, { "citation": "Koestenberger M, et al. Neonatology 2011;100:85-92 (Table 1)", "doi": "10.1159/000322006" }, { "citation": "Koestenberger M, et al. J Am Soc Echocardiogr 2009;22:715-9 (Table 1)", "doi": "10.1016/j.echo.2009.03.026" }, { "citation": "Ghandi Y, et al. J Cardiovasc Echogr 2018;28:177-181", "doi": "10.4103/jcecho.jcecho_31_18" }, { "citation": "Koestenberger M, et al. Neonatology 2013;103:281-6", "doi": "10.1159/000348521" }, { "citation": "Levy PT, et al. J Am Soc Echocardiogr 2015;28:559-69 (Table 2)", "doi": "10.1016/j.echo.2015.01.024" }, { "citation": "Jain A, et al. J Am Soc Echocardiogr 2014;27:1293-304", "doi": "10.1016/j.echo.2014.08.018" }, { "citation": "Patel MD, et al. J Am Soc Echocardiogr 2019;32:884-894.e4 (Tables 2-3)", "doi": "10.1016/j.echo.2019.03.015" }, { "citation": "Koestenberger M, et al. Circ Cardiovasc Imaging 2017;10:e005336 (Table 3)", "doi": "10.1161/CIRCIMAGING.116.005336" }, { "citation": "Levy PT, et al. J Am Soc Echocardiogr 2016;29:1056-1065", "doi": "10.1016/j.echo.2016.08.013" }, { "citation": "Abraham S, Weismann CG. Echocardiography 2016;33:910-5 (Table I)", "doi": "10.1111/echo.13171" }, { "citation": "Choudhry S, et al. J Am Soc Echocardiogr 2017;30:781-789.e4", "doi": "10.1016/j.echo.2017.04.010" }, { "citation": "Koestenberger M, et al. Pediatr Cardiol 2015;36:20-6", "doi": "10.1007/s00246-014-0959-6" }, { "citation": "Mori K, et al. Heart 2004;90:175-80 (values as tabulated in Nestaas E, et al. Pediatr Res 2018;84(Suppl 1):18-29, Table 2)", "doi": "10.1136/hrt.2002.008110" }, { "citation": "Breatnach CR, et al. Early Hum Dev 2017;108:33-39", "doi": "10.1016/j.earlhumdev.2017.03.012" }, { "citation": "Kozák-Bárány A, et al. J Pediatr 2001;139:539-45", "doi": "10.1067/mpd.2001.118199" }, { "citation": "El-Khuffash A, et al. Pediatr Res 2018;84(Suppl 1):30-45", "doi": "10.1038/s41390-018-0080-2" }, { "citation": "Mertens L, et al. J Am Soc Echocardiogr 2011;24:1057-78", "doi": "10.1016/j.echo.2011.07.014" }, { "citation": "McNamara PJ, et al. J Am Soc Echocardiogr 2024;37:171-215", "doi": "10.1016/j.echo.2023.11.016" }, { "citation": "de Boode WP, et al. Pediatr Res 2016;80:465-71", "doi": "10.1038/pr.2016.126" }, { "citation": "Pediatr Res 2018;84(Suppl 1):1-88", "doi": "10.1038/s41390-018-0076-y" } ], "prefill_example": "https://heartcalc.doctorarichai.com/neonatal-echo-ref?trv=3&rap=5&sbp=50" }, { "id": "cchd-screen", "name": "CCHD Pulse-Ox Screen", "url": "https://heartcalc.doctorarichai.com/cchd-screen", "status": "verified", "group": "icu", "group_label": "NICU & CICU", "description": "Newborn critical congenital heart disease screening with the updated AAP algorithm: right hand and foot SpO2 for up to two screens.", "keywords": "pulse oximetry newborn screening cchd critical congenital heart disease spo2", "population": "Asymptomatic newborns in room air, screened at 24 hours of age or later (earlier screens give more false positives). Not for babies with signs of CCHD, a prenatal or known CHD diagnosis, or on supplemental oxygen: they need an echocardiogram or clinical evaluation instead.", "method_url": "https://heartcalc.doctorarichai.com/cchd-screen#method", "inputs": [ { "name": "symptomatic", "label": "Signs of CCHD, or a prenatal or known diagnosis of CHD", "type": "checkbox", "unit": null, "required": false, "notes": "Cyanosis, poor perfusion, respiratory distress, murmur needing evaluation. These infants need evaluation, not a screen." }, { "name": "onO2", "label": "Receiving supplemental oxygen", "type": "checkbox", "unit": null, "required": false, "notes": "The screen is done in room air." }, { "name": "ageH", "label": "Age at first screen", "type": "number", "unit": "hours", "min": 0, "required": false, "notes": null }, { "name": "rh1", "label": "Right hand SpO2, first screen", "type": "number", "unit": "%", "required": true, "notes": null }, { "name": "foot1", "label": "Foot SpO2, first screen", "type": "number", "unit": "%", "required": true, "notes": null }, { "name": "rh2", "label": "Right hand SpO2, repeat screen", "type": "number", "unit": "%", "required": false, "notes": null }, { "name": "foot2", "label": "Foot SpO2, repeat screen", "type": "number", "unit": "%", "required": false, "notes": null } ], "input_notes": "rh1 and foot1 are the first screen (right hand, foot). rh2 and foot2 are the single repeat screen, used only when the first screen calls for it.", "outputs": [ "Pass, repeat or fail by the updated AAP algorithm (2020; AAP 2025 clinical report)", "The path taken through the algorithm", "The next step" ], "sources": [ { "citation": "Martin GR, Ewer AK, Gaviglio A, et al. Updated strategies for pulse oximetry screening for critical congenital heart disease. Pediatrics 2020;146(1):e20191650. doi:10.1542/peds.2019-1650", "doi": "10.1542/peds.2019-1650" }, { "citation": "Oster ME, Pinto NM, Pramanik AK, et al. Newborn screening for critical congenital heart disease: a new algorithm and other updated recommendations: clinical report. Pediatrics 2025;155(1):e2024069667. doi:10.1542/peds.2024-069667", "doi": "10.1542/peds.2024-069667" } ], "prefill_example": "https://heartcalc.doctorarichai.com/cchd-screen?ageH=26&rh1=97&foot1=93&rh2=98&foot2=96" }, { "id": "borderline-lv", "name": "Borderline LV Scores", "url": "https://heartcalc.doctorarichai.com/borderline-lv", "status": "experimental", "group": "echo", "group_label": "Echo", "description": "What the Rhodes 1991 and Colan 2006 discriminant scores and the Cohen AV valve index say about biventricular candidacy, with an automatic measurement sensitivity band.", "keywords": "rhodes colan avvi biventricular univentricular aortic stenosis hypoplastic", "population": "Choose the lesion first. Critical left-heart obstruction (critical AS / HLHS spectrum): the Rhodes 1991 and Colan 2006 scores apply only to neonates with critical valvar aortic stenosis (Colan also needs mitral valve area z > -2 and Boston z scores, the derivation reference). Unbalanced AVSD with a small left ventricle: the Cohen 1996 AV valve index. Scores built for the other lesion are never counted. Derived decades ago in single centres; decision support for surgical conference, not a decision rule. The CHSS models (Lofland 2001; Hickey 2007 UVR-SA, critical LVOTO) are explained but not calculated because their coefficients could not be verified.", "method_url": "https://heartcalc.doctorarichai.com/borderline-lv#method", "inputs": [ { "name": "lesion", "label": "Lesion", "type": "radio", "unit": null, "options": [ { "value": "lvoto", "label": "Critical AS / HLHS spectrum" }, { "value": "uavsd", "label": "Unbalanced AVSD" } ], "required": true, "notes": "Each score was built in one population. Rhodes 1991 and Colan 2006: neonates with critical valvar aortic stenosis (Boston). Rhodes 1991 included aortic stenosis diagnosed in the first 2 months of life with LV dysfunction and heart failure, normally related great arteries, patent aortic and mitral valves, and no subvalvar or supravalvar stenosis or VSD. AV valve index: unbalanced common AV canal with a small left ventricle (Cohen 1996, Philadelphia). Scores built for the other lesion are listed as not applicable and never count toward the bottom line. Only the scores built for this lesion count." }, { "name": "pop", "label": "Neonate with valvar aortic stenosis (critical AS)?", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": "Rhodes and Colan were derived only in this population. The AV valve index is separate." }, { "name": "bsa", "label": "BSA", "type": "number", "unit": "m²", "min": 0, "required": false, "notes": null }, { "name": "rootMm", "label": "Aortic root diameter", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "mv1", "label": "Mitral annulus, 4-chamber", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "mv2", "label": "Mitral annulus, long axis", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "lvL", "label": "LV long axis", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "hL", "label": "Heart long axis", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "lvmi", "label": "LV mass index (optional)", "type": "number", "unit": "g/m²", "min": 0, "required": false, "notes": null }, { "name": "zRef", "label": "Z-score reference used for these values", "type": "select", "unit": null, "options": [ { "value": "boston", "label": "Boston (derivation reference)" }, { "value": "phn", "label": "PHN (Lopez 2017)" }, { "value": "detroit", "label": "Detroit (Pettersen 2008)" }, { "value": "other", "label": "Other" } ], "required": false, "notes": null }, { "name": "annZ", "label": "Aortic annulus", "type": "number", "unit": "z", "required": false, "notes": null }, { "name": "mvZ", "label": "Mitral valve area", "type": "number", "unit": "z", "required": false, "notes": null }, { "name": "efe", "label": "EFE grade 2 or 3?", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": null }, { "name": "lavv", "label": "Left AV valve area", "type": "number", "unit": "cm²", "min": 0, "required": false, "notes": null }, { "name": "ravv", "label": "Right AV valve area", "type": "number", "unit": "cm²", "min": 0, "required": false, "notes": null }, { "name": "vsdLarge", "label": "Large ventricular component (VSD)?", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": "Cohen 1996 advises a single-ventricle approach for AVVI below 0.67 only when the VSD is large." } ], "input_notes": "lesion=lvoto (critical AS / HLHS spectrum) counts Rhodes and Colan, which also need pop=yes. Rhodes uses bsa, rootMm, mv1, mv2, lvL, hL (and lvmi for the threshold score, not counted). Colan uses bsa, the long axes, annZ, mvZ, efe and zRef. lesion=uavsd counts the AV valve index: lavv and ravv, plus vsdLarge when the index is below 0.67.", "outputs": [ "Bottom line for the chosen lesion: scores favour biventricular repair, favour single-ventricle palliation, or borderline (disagree, within measurement uncertainty, or dependent on the Rhodes MV area formula), with the count of applicable scores", "Per score: value, cut-off, what it favours, and whether its sensitivity band crosses the cut-off; not-applicable and missing-input scores listed but not counted", "Rhodes 1991 score and its cutoff", "Colan 2006 discriminant score and its cutoff", "Sensitivity band from ±5% measurement and ±0.5 z variation", "Cohen AV valve index and balance category", "CHSS models explained (variables, sign convention, external validation); not calculated" ], "sources": [ { "citation": "Colan SD, McElhinney DB, Crawford EC, Keane JF, Lock JE. Validation and re-evaluation of a discriminant model predicting anatomic suitability for biventricular repair in neonates with aortic stenosis. J Am Coll Cardiol 2006;47(9):1858-1865. doi:10.1016/j.jacc.2006.02.020", "doi": "10.1016/j.jacc.2006.02.020" }, { "citation": "Wang et al. Clin Exp Pediatr 2025 (comparison table listing the Colan discriminant cutoff).", "doi": "10.3345/cep.2025.02110" }, { "citation": "den Dekker et al. J Am Soc Echocardiogr 2013 (Z-score references are not interchangeable in small left hearts).", "doi": "10.1016/j.echo.2013.07.022" }, { "citation": "Rhodes LA, Colan SD, Perry SB, Jonas RA, Sanders SP. Predictors of survival in neonates with critical aortic stenosis. Circulation 1991;84(6):2325-2335. doi:10.1161/01.cir.84.6.2325", "doi": "10.1161/01.cir.84.6.2325" }, { "citation": "Cross-check: two reviews restate the same coefficients and cut-off. Ma XJ, Huang GY, Chin Med J 2019 (doi:10.1097/CM9.0000000000000375)", "doi": "10.1097/CM9.0000000000000375" }, { "citation": "Mazza GA et al., Diagnostics 2024 (doi:10.3390/diagnostics14080823)", "doi": "10.3390/diagnostics14080823" }, { "citation": "Cohen MS, Jacobs ML, Weinberg PM, Rychik J. Morphometric analysis of unbalanced common atrioventricular canal using two-dimensional echocardiography. J Am Coll Cardiol 1996;28(4):1017-1023. doi:10.1016/s0735-1097(96)00262-8", "doi": "10.1016/s0735-1097(96)00262-8" }, { "citation": "Lofland GK, McCrindle BW, Williams WG, Blackstone EH, Tchervenkov CI, Sittiwangkul R, Jonas RA. Critical aortic stenosis in the neonate: a multi-institutional study of management, outcomes, and risk factors. J Thorac Cardiovasc Surg 2001;121(1):10-27. doi:10.1067/mtc.2001.111207", "doi": "10.1067/mtc.2001.111207" }, { "citation": "Cantinotti M et al. Healthcare 2024 (review table listing the z-score source of Lofland 2001).", "doi": "10.3390/healthcare12030348" }, { "citation": "Hickey EJ, Caldarone CA, Blackstone EH, Lofland GK, Yeh T, Pizarro C, Tchervenkov CI, Pigula F, Overman DM, Jacobs ML, McCrindle BW, et al. Critical left ventricular outflow tract obstruction: the disproportionate impact of biventricular repair in borderline cases. J Thorac Cardiovasc Surg 2007;134(6):1429-1436. doi:10.1016/j.jtcvs.2007.07.052", "doi": "10.1016/j.jtcvs.2007.07.052" }, { "citation": "Eicken A et al. Neonatal balloon aortic valvuloplasty: predictive value of current risk score algorithms for treatment strategies. Catheter Cardiovasc Interv 2010;76(3):404-410 (external check of Rhodes, Colan and the CHSS UVR-SA).", "doi": "10.1002/ccd.22363" }, { "citation": "Sachdeva S, Kuhn E, Frommelt PC, Handler S. Role of echocardiographic scoring systems in predicting successful biventricular versus univentricular palliation in neonates with critical aortic stenosis. Cardiol Young 2020;30(11):1702-1707 (external check of Rhodes, CHSS 1, discriminant and CHSS 2).", "doi": "10.1017/S1047951120002607" }, { "citation": "Mart CR, Eckhauser AW. Development of an echocardiographic scoring system to predict biventricular repair in neonatal hypoplastic left heart complex. Pediatr Cardiol 2014;35(8):1456-1466 (compares Rhodes, CHSS and the discriminant).", "doi": "10.1007/s00246-014-1009-0" }, { "citation": "Minich LL, Tani LY, Hawkins JA, Shaddy RE. Possibility of postnatal left ventricular growth in selected infants with non-apex-forming left ventricles. Am Heart J 1997;133(5):570-574 (group means reproduce the Rhodes equation).", "doi": "10.1016/s0002-8703(97)70152-2" } ], "prefill_example": "https://heartcalc.doctorarichai.com/borderline-lv?lesion=lvoto&pop=yes&bsa=0.21&rootMm=8&mv1=9&mv2=8&lvL=26&hL=33&lvmi=40&zRef=boston&annZ=-2.5&mvZ=-1&efe=no" }, { "id": "fetal", "name": "Fetal Echo", "url": "https://heartcalc.doctorarichai.com/fetal", "status": "verified", "group": "echo", "group_label": "Echo", "description": "Fetal cardiac Z scores by gestational age or femur length and the 10-point Cardiovascular Profile Score.", "keywords": "fetal echo z-score cvps cardiovascular profile score schneider pasquini", "population": "Fetuses having fetal echocardiography. Schneider 2005 Z scores: 15 to 39 completed weeks (days not used); Pasquini 2007 isthmus and duct: 18+4 to 37+3 weeks (weeks + days); the page warns outside each range. Femur-length mode accepts 10 to 76 mm. The Cardiovascular Profile Score applies to fetal heart failure and hydrops assessment; its point criteria come from secondary sources and are not verified.", "method_url": "https://heartcalc.doctorarichai.com/fetal#method", "inputs": [ { "name": "mode", "label": "Calculate Z scores from", "type": "radio", "unit": null, "options": [ { "value": "ga", "label": "Gestational age" }, { "value": "fl", "label": "Femur length" } ], "required": true, "notes": null }, { "name": "gaW", "label": "Gestational age", "type": "number", "unit": "weeks", "min": 0, "required": false, "notes": null }, { "name": "gaD", "label": "Gestational age, days", "type": "number", "unit": "d", "min": 0, "max": 6, "required": false, "notes": null }, { "name": "fl", "label": "Femur length", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": "Used when mode is fl." }, { "name": "m_mv", "label": "Mitral valve", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_tv", "label": "Tricuspid valve", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_av", "label": "Aortic valve", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_pv", "label": "Pulmonary valve", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_aao", "label": "Ascending aorta", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_mpa", "label": "Main pulmonary artery", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_rpa", "label": "Right pulmonary artery", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_lpa", "label": "Left pulmonary artery", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_dao", "label": "Descending aorta", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_lvmin", "label": "LV end-diastolic dimension (LV EDD)", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_lvmaj", "label": "LV inlet length", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_rvmin", "label": "RV end-diastolic dimension (RV EDD)", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_rvmaj", "label": "RV inlet length", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_isthS", "label": "Aortic isthmus, sagittal", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_isth3", "label": "Aortic isthmus, 3VT view", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_duct3", "label": "Arterial duct, 3VT view", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "hydrops", "label": "Hydrops", "type": "radio", "unit": null, "options": [ { "value": "none", "label": "None" }, { "value": "effusion", "label": "Ascites, pleural or pericardial effusion" }, { "value": "skin", "label": "Skin edema" } ], "required": false, "notes": null }, { "name": "venous", "label": "Venous Doppler (umbilical vein and ductus venosus)", "type": "radio", "unit": null, "options": [ { "value": "normal", "label": "Normal UV and DV" }, { "value": "dvA", "label": "Reversed (negative) a-wave in the DV, non-pulsatile UV" }, { "value": "uvPulse", "label": "Umbilical venous pulsations" } ], "required": false, "notes": null }, { "name": "ctar", "label": "Heart size: heart/chest area ratio", "type": "number", "unit": "ratio", "min": 0, "max": 1, "required": false, "notes": "Example: 0.30." }, { "name": "fn", "label": "Cardiac function", "type": "radio", "unit": null, "options": [ { "value": "normal", "label": "Normal TV and MV, RV and LV shortening fraction >0.28, biphasic diastolic filling" }, { "value": "mild", "label": "Holosystolic TR, or RV or LV shortening fraction <0.28" }, { "value": "severe", "label": "Holosystolic MR, TR dP/dt <400 mmHg/s, or monophasic diastolic filling" } ], "required": false, "notes": null }, { "name": "arterial", "label": "Arterial Doppler (umbilical artery)", "type": "radio", "unit": null, "options": [ { "value": "normal", "label": "Normal (forward end-diastolic flow)" }, { "value": "aedv", "label": "Absent end-diastolic flow" }, { "value": "redv", "label": "Reversed end-diastolic flow" } ], "required": false, "notes": null } ], "input_notes": "mode=ga uses gaW (whole weeks) plus gaD (0-6 days): Schneider equations use the completed weeks only, Pasquini weeks + days; mode=fl uses fl (femur length, mm). Measurements are m_ in mm. The CVPS uses hydrops, venous, ctar, fn and arterial.", "outputs": [ "Z score, mean and normal range for 16 fetal cardiac structures", "Cardiovascular Profile Score (0 to 10) with point deductions by category (point criteria from secondary sources, not verified)" ], "sources": [ { "citation": "Schneider C, McCrindle BW, Carvalho JS, Hornberger LK, McCarthy KP, Daubeney PEF. Development of Z-scores for fetal cardiac dimensions from echocardiography. Ultrasound Obstet Gynecol 2005;26(6):599-605. doi:10.1002/uog.2597", "doi": "10.1002/uog.2597" }, { "citation": "Pasquini L, Mellander M, Seale A, et al. Z-scores of the fetal aortic isthmus and duct: an aid to assessing arch hypoplasia. Ultrasound Obstet Gynecol 2007;29(6):628-633. doi:10.1002/uog.4021", "doi": "10.1002/uog.4021" }, { "citation": "Huhta JC. Guidelines for the evaluation of heart failure in the fetus with or without hydrops. Pediatr Cardiol 2004;25(3):274-286. doi:10.1007/s00246-003-0591-3", "doi": "10.1007/s00246-003-0591-3" }, { "citation": "Falkensammer CB, Paul J, Huhta JC. Fetal congestive heart failure: correlation of Tei-index and cardiovascular-score. J Perinat Med 2001;29(5):390-398. doi:10.1515/JPM.2001.055", "doi": "10.1515/JPM.2001.055" }, { "citation": "Hofstaetter C, Hansmann M, Eik-Nes SH, Huhta JC, Luther SL. A cardiovascular profile score in the surveillance of fetal hydrops. J Matern Fetal Neonatal Med 2006;19(7):407-413. doi:10.1080/14767050600682446", "doi": "10.1080/14767050600682446" }, { "citation": "Review reproducing the Huhta CVPS table (modified from Huhta 2004). Diagnostics 2023.", "doi": "10.3390/diagnostics13040779" }, { "citation": "Review reproducing the Huhta CVPS table. Diagnostics 2025.", "doi": "10.3390/diagnostics15182303" } ], "prefill_example": "https://heartcalc.doctorarichai.com/fetal?mode=ga&gaW=24&gaD=0&m_mv=6&m_tv=7&m_av=4&m_pv=5&m_aao=4.5&m_mpa=5.5&m_isth3=3.2&m_duct3=4&hydrops=effusion&venous=normal&ctar=0.38&fn=mild&arterial=normal" }, { "id": "cath-plus", "name": "Cath Extensions", "url": "https://heartcalc.doctorarichai.com/cath-plus", "status": "verified", "group": "cath", "group_label": "Cath & Surgery", "description": "Glenn/Fontan PVRi from Qp, Nakata and McGoon PA indices, Gorlin valve area, and AHA/ATS 2015 vasoreactivity response.", "keywords": "glenn fontan tpg pvri nakata mcgoon gorlin valve area vasoreactivity", "population": "Patients in the cath lab: Glenn or Fontan (cavopulmonary) circulations for PVRi; pulmonary artery size (Nakata index, McGoon ratio, e.g. tetralogy with pulmonary atresia); stenotic valves (Gorlin and Hakki valve area); and acute vasoreactivity testing in pulmonary hypertension (IPAH CCB responsiveness or shunt operability).", "method_url": "https://heartcalc.doctorarichai.com/cath-plus#method", "inputs": [ { "name": "mod", "label": "Module", "type": "radio", "unit": null, "options": [ { "value": "cavo", "label": "Glenn / Fontan" }, { "value": "pa", "label": "PA size" }, { "value": "valve", "label": "Valve area" }, { "value": "avt", "label": "Vasoreactivity" } ], "default": "cavo", "required": true, "notes": null }, { "name": "circ", "label": "Circulation", "type": "radio", "unit": null, "options": [ { "value": "glenn", "label": "Glenn (SVC to PA)" }, { "value": "fontan", "label": "Fontan (TCPC)" } ], "required": false, "notes": null }, { "name": "extraFlow", "label": "Additional pulmonary blood flow", "type": "checkbox", "unit": null, "required": false, "notes": "Antegrade flow, a systemic-to-PA shunt or aortopulmonary collaterals. A Fick Qp from one PA saturation is then unreliable." }, { "name": "fenestration", "label": "Fenestrated Fontan", "type": "checkbox", "unit": null, "required": false, "notes": "Qp is then less than Qs: PVRi must use Qp, not the cardiac index." }, { "name": "cMPA", "label": "Mean cavopulmonary or PA pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "cMAtr", "label": "Mean common atrial, LA or PCWP pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "qpMode", "label": "How do you have Qp?", "type": "radio", "unit": null, "options": [ { "value": "direct", "label": "I have Qp index" }, { "value": "fick", "label": "Fick from saturations + VO₂" } ], "required": false, "notes": "In a cavopulmonary circulation Qp is caval flow reaching the lungs. Nothing is assumed: choose one." }, { "name": "cQpi", "label": "Qp index", "type": "number", "unit": "L/min/m²", "required": false, "notes": null }, { "name": "cVo2i", "label": "VO₂ index", "type": "number", "unit": "mL/min/m²", "required": false, "notes": null }, { "name": "cVo2Src", "label": "VO₂ source", "type": "select", "unit": null, "options": [ { "value": "measured", "label": "Measured" }, { "value": "predicted", "label": "Predicted / assumed" } ], "required": false, "notes": null }, { "name": "cHgb", "label": "Hemoglobin", "type": "number", "unit": "g/dL", "required": false, "notes": null }, { "name": "cPv", "label": "Pulmonary vein sat", "type": "number", "unit": "%", "required": false, "notes": null }, { "name": "cPvSrc", "label": "PV sat source", "type": "select", "unit": null, "options": [ { "value": "measured", "label": "Measured" }, { "value": "assumed", "label": "Assumed" } ], "required": false, "notes": null }, { "name": "cPa", "label": "PA sat", "type": "number", "unit": "%", "required": false, "notes": null }, { "name": "pRpa", "label": "RPA diameter", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "pLpa", "label": "LPA diameter", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "pDao", "label": "Descending aorta at diaphragm", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "pHt", "label": "Height", "type": "number", "unit": "cm", "required": false, "notes": null }, { "name": "pWt", "label": "Weight", "type": "number", "unit": "kg", "required": false, "notes": null }, { "name": "pBsaOv", "label": "BSA override", "type": "number", "unit": "m²", "required": false, "notes": "Optional." }, { "name": "valve", "label": "Valve", "type": "radio", "unit": null, "options": [ { "value": "aortic", "label": "Aortic (C = 1)" }, { "value": "mitral", "label": "Mitral (C = 0.85)" } ], "required": false, "notes": null }, { "name": "vCo", "label": "Flow across the valve", "type": "number", "unit": "L/min", "required": false, "notes": null }, { "name": "vHr", "label": "Heart rate", "type": "number", "unit": "bpm", "required": false, "notes": null }, { "name": "vBsa", "label": "BSA", "type": "number", "unit": "m²", "required": false, "notes": "Optional to index." }, { "name": "vMean", "label": "Mean gradient", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "vP2p", "label": "Peak-to-peak gradient", "type": "number", "unit": "mmHg", "required": false, "notes": "Optional (Hakki)." }, { "name": "vPeriod", "label": "Ejection or filling period per beat", "type": "number", "unit": null, "required": false, "notes": "Unit set by periodUnit." }, { "name": "periodUnit", "label": "Unit of the period", "type": "radio", "unit": null, "options": [ { "value": "ms", "label": "ms" }, { "value": "s", "label": "s" } ], "required": false, "notes": "Required: 330 ms and 0.33 s differ by 1000×." }, { "name": "aGroup", "label": "Testing for", "type": "select", "unit": null, "options": [ { "value": "ipah", "label": "IPAH / heritable PAH (CCB responsiveness)" }, { "value": "chd", "label": "CHD with a shunt (operability)" }, { "value": "other", "label": "Other" } ], "required": false, "notes": null }, { "name": "aAgent", "label": "Vasodilator", "type": "select", "unit": null, "options": [ { "value": "no", "label": "Inhaled NO alone" }, { "value": "no_o2", "label": "Inhaled NO + high FiO₂" }, { "value": "o2", "label": "High FiO₂ alone" }, { "value": "other", "label": "Other (prostacyclin, adenosine, sildenafil)" } ], "required": false, "notes": null }, { "name": "shunt", "label": "Shunt", "type": "radio", "unit": null, "options": [ { "value": "none", "label": "No shunt (Qp = Qs)" }, { "value": "yes", "label": "Shunt: enter Qp and Qs" } ], "required": false, "notes": "Without a shunt Qp = Qs, so one cardiac index serves both." }, { "name": "bMPA", "label": "Baseline mean PA pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "bMLA", "label": "Baseline mean LA pressure or PCWP", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "bMAo", "label": "Baseline mean aortic pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "bMRA", "label": "Baseline mean RA pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "bCI", "label": "Baseline cardiac index", "type": "number", "unit": "L/min/m²", "required": false, "notes": null }, { "name": "bQpi", "label": "Baseline Qp index", "type": "number", "unit": "L/min/m²", "required": false, "notes": null }, { "name": "bQsi", "label": "Baseline Qs index", "type": "number", "unit": "L/min/m²", "required": false, "notes": null }, { "name": "tMPA", "label": "During vasodilator testing, mean PA pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "tMLA", "label": "During vasodilator testing, mean LA pressure or PCWP", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "tMAo", "label": "During vasodilator testing, mean aortic pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "tMRA", "label": "During vasodilator testing, mean RA pressure", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "tCI", "label": "During vasodilator testing, cardiac index", "type": "number", "unit": "L/min/m²", "required": false, "notes": null }, { "name": "tQpi", "label": "During vasodilator testing, Qp index", "type": "number", "unit": "L/min/m²", "required": false, "notes": null }, { "name": "tQsi", "label": "During vasodilator testing, Qs index", "type": "number", "unit": "L/min/m²", "required": false, "notes": null } ], "input_notes": "mod picks the module: cavo (Glenn/Fontan; c* fields), pa (PA size; p* fields), valve (valve area; v* fields), avt (vasoreactivity; b* baseline and t* test fields). Unit radios have no default.", "outputs": [ "Cavopulmonary TPG and PVRi with the Qp assumption stated", "Nakata index and McGoon ratio", "Gorlin and Hakki valve area (and indexed)", "AHA/ATS 2015 vasoreactivity response and operability thresholds" ], "sources": [ { "citation": "Abman SH, Hansmann G, Archer SL, et al. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society. Circulation 2015;132(21):2037-2099. doi:10.1161/CIR.0000000000000329", "doi": "10.1161/CIR.0000000000000329" }, { "citation": "Rosenzweig EB, Abman SH, Adatia I, et al. Paediatric pulmonary arterial hypertension: updates on definition, classification, diagnostics and management. Eur Respir J 2019;53(1):1801916. doi:10.1183/13993003.01916-2018", "doi": "10.1183/13993003.01916-2018" }, { "citation": "McGoon ratio definition as described in: Correlating computed tomographic angiography of pulmonary circulation with clinical course and disease burden in patients with tetralogy of Fallot and pulmonary atresia. Eur J Radiol Open 2021;8:100363. doi:10.1016/j.ejro.2021.100363", "doi": "10.1016/j.ejro.2021.100363" }, { "citation": "Gorlin R, Gorlin SG. Hydraulic formula for calculation of the area of the stenotic mitral valve, other cardiac valves, and central circulatory shunts. I. Am Heart J 1951;41(1):1-29. doi:10.1016/0002-8703(51)90002-6", "doi": "10.1016/0002-8703(51)90002-6" }, { "citation": "Cohen MV, Gorlin R. Modified orifice equation for the calculation of mitral valve area. Am Heart J 1972;84(6):839-840. doi:10.1016/0002-8703(72)90080-4", "doi": "10.1016/0002-8703(72)90080-4" }, { "citation": "Hakki AH, Iskandrian AS, Bemis CE, et al. A simplified valve formula for the calculation of stenotic cardiac valve areas. Circulation 1981;63(5):1050-1055. doi:10.1161/01.cir.63.5.1050", "doi": "10.1161/01.cir.63.5.1050" }, { "citation": "Dean LS, Kern MJ. Measuring Valve Gradients and Areas. J Soc Cardiovasc Angiogr Interv 2022;1(5):100433. doi:10.1016/j.jscai.2022.100433", "doi": "10.1016/j.jscai.2022.100433" } ], "prefill_example": "https://heartcalc.doctorarichai.com/cath-plus?mod=cavo&circ=glenn&qpMode=fick&cMPA=13&cMAtr=6&cVo2i=150&cVo2Src=measured&cHgb=15&cPv=97&cPvSrc=assumed&cPa=65" }, { "id": "prais2", "name": "PRAiS2 Surgical Risk", "url": "https://heartcalc.doctorarichai.com/prais2", "status": "experimental", "group": "cath", "group_label": "Cath & Surgery", "description": "What the UK PRAiS2 model for 30-day mortality after pediatric cardiac surgery is, why it is not reproduced here, where to run it, and observed/expected arithmetic for its outputs. Research and audit use only.", "keywords": "prais uk surgical mortality risk adjustment observed expected", "population": "UK paediatric cardiac surgery audit (research and audit use only). Not a calculator for one child's operative risk, consent or counselling: the page does not reproduce PRAiS2 and links to the official UCL software. The audit helper takes predicted risks produced by that software, with outcomes.", "method_url": "https://heartcalc.doctorarichai.com/prais2#method", "inputs": [ { "name": "scale", "label": "Risk values are", "type": "radio", "unit": null, "options": [ { "value": "percent", "label": "Percent (0–100)" }, { "value": "proportion", "label": "Proportion (0–1)" } ], "required": true, "notes": "No default. A wrong choice changes expected deaths 100-fold." }, { "name": "rows", "label": "Audit rows", "type": "text", "unit": null, "required": true, "notes": "One episode per line: predicted risk, outcome (1 died, 0 survived). Lines starting with # are ignored." } ], "input_notes": "rows is one episode per line: predicted risk, outcome (1 died, 0 survived). scale says whether risks are percent or proportion; there is no default.", "outputs": [ "What PRAiS2 is and its published performance", "Observed and expected deaths, O/E ratio", "Cumulative expected minus observed deaths (VLAD) from official outputs" ], "sources": [ { "citation": "Rogers L, Brown KL, Franklin RC, et al. Improving risk adjustment for mortality after pediatric cardiac surgery: the UK PRAiS2 model. Ann Thorac Surg 2017;104(1):211-219. doi:10.1016/j.athoracsur.2016.12.014", "doi": "10.1016/j.athoracsur.2016.12.014" }, { "citation": "Brown KL, Rogers L, Barron DJ, et al. Incorporating comorbidity within risk adjustment for UK pediatric cardiac surgery. Ann Thorac Surg 2017;104(1):220-226. doi:10.1016/j.athoracsur.2016.12.013", "doi": "10.1016/j.athoracsur.2016.12.013" } ], "prefill_example": "https://heartcalc.doctorarichai.com/prais2?scale=percent&rows=0.6%2C%200%0A1.8%2C%200%0A4.2%2C%200%0A22.5%2C%200%0A35.0%2C%201" }, { "id": "echo-z", "name": "Echo Z-Scores", "url": "https://heartcalc.doctorarichai.com/echo-z", "status": "verified", "group": "echo", "group_label": "Echo", "description": "Pediatric Heart Network (Lopez 2017) Z scores for 35 2D echo measurements, with expected mean and normal range, and Detroit alongside.", "keywords": "z-score phn lopez detroit pettersen dimensions measurements", "population": "Children 0 to 18 years with echo measurements (PHN normal database, Lopez 2017; preterm infants were excluded, and the page cautions below BSA 0.2 m2). Detroit (Pettersen 2008) Z scores are shown alongside and flagged unverified.", "method_url": "https://heartcalc.doctorarichai.com/echo-z#method", "inputs": [ { "name": "ageY", "label": "Age", "type": "number", "unit": "years", "min": 0, "required": true, "notes": null }, { "name": "ht", "label": "Height", "type": "number", "unit": "cm", "min": 0, "required": true, "notes": null }, { "name": "wt", "label": "Weight", "type": "number", "unit": "kg", "min": 0, "required": true, "notes": null }, { "name": "unit", "label": "Diameters and lengths entered in", "type": "radio", "unit": null, "options": [ { "value": "mm", "label": "mm" }, { "value": "cm", "label": "cm" } ], "required": true, "notes": "Required. Areas are always cm²." }, { "name": "v_ANN", "label": "Aortic valve annulus", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal long-axis." }, { "name": "v_ROOT", "label": "Aortic root (sinuses of Valsalva)", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal long-axis." }, { "name": "v_STJ", "label": "Sinotubular junction", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal long-axis." }, { "name": "v_AAO", "label": "Ascending aorta", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal long-axis." }, { "name": "v_ARCHPROX", "label": "Proximal transverse arch", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Suprasternal long-axis." }, { "name": "v_ARCHDIST", "label": "Distal transverse arch", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Suprasternal long-axis." }, { "name": "v_ISTH", "label": "Aortic isthmus", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Suprasternal long-axis." }, { "name": "v_MVAP", "label": "Mitral annulus, AP diameter", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal long-axis." }, { "name": "v_MVLAT", "label": "Mitral annulus, lateral diameter", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Apical four-chamber." }, { "name": "v_TVAP", "label": "Tricuspid annulus, AP diameter", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal long-axis." }, { "name": "v_TVLAT", "label": "Tricuspid annulus, lateral diameter", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Apical four-chamber." }, { "name": "v_PVSAX", "label": "Pulmonary annulus (short-axis view)", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis." }, { "name": "v_PVLAX", "label": "Pulmonary annulus (long-axis view)", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal long-axis." }, { "name": "v_MPA", "label": "Main pulmonary artery", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis." }, { "name": "v_RPA", "label": "Right pulmonary artery", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis." }, { "name": "v_LPA", "label": "Left pulmonary artery", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis." }, { "name": "v_LVEDD", "label": "LV end-diastolic diameter", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis (2D)." }, { "name": "v_LVESD", "label": "LV end-systolic diameter", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). PHN method (Lopez 2021)." }, { "name": "v_LVST", "label": "LV septal thickness, diastole", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis (2D)." }, { "name": "v_LVPWT", "label": "LV posterior wall, diastole", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis (2D)." }, { "name": "v_LVEDL", "label": "LV end-diastolic length, endocardial", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Apical four-chamber." }, { "name": "v_LVEDLEPI", "label": "LV end-diastolic length, epicardial", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Apical four-chamber." }, { "name": "v_LVEDA", "label": "LV end-diastolic area, endocardial", "type": "number", "unit": "cm2", "required": false, "notes": "Always cm2. Parasternal short-axis." }, { "name": "v_LVEDAEPI", "label": "LV end-diastolic area, epicardial", "type": "number", "unit": "cm2", "required": false, "notes": "Always cm2. Parasternal short-axis." }, { "name": "v_LMCA", "label": "Left main coronary artery", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis." }, { "name": "v_LAD", "label": "Proximal LAD", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis." }, { "name": "v_RCA", "label": "Proximal RCA", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice (mm or cm). Parasternal short-axis." } ], "input_notes": "Measurements are v_. Lengths follow the unit radio (mm or cm, no default); areas are always cm2. Derived values are calculated, never typed.", "outputs": [ "PHN Z score, expected mean and normal range for 35 2D measurements", "Derived areas, LV volumes and mass from their components", "Detroit comparison Z scores (unverified)", "Haycock BSA" ], "sources": [ { "citation": "Lopez L, Colan S, Stylianou M, et al. Relationship of echocardiographic Z scores adjusted for body surface area to age, sex, race, and ethnicity: the Pediatric Heart Network Normal Echocardiogram Database. Circ Cardiovasc Imaging 2017;10(11):e006979. doi:10.1161/CIRCIMAGING.117.006979", "doi": "10.1161/CIRCIMAGING.117.006979" }, { "citation": "Lopez L, Frommelt PC, Colan SD, et al. Pediatric Heart Network echocardiographic Z scores: comparison to other published models. J Am Soc Echocardiogr 2021;34(2):185-192. doi:10.1016/j.echo.2020.09.019", "doi": "10.1016/j.echo.2020.09.019" }, { "citation": "Pettersen MD, Du W, Skeens ME, Humes RA. Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study. J Am Soc Echocardiogr 2008;21(8):922-934. doi:10.1016/j.echo.2008.02.006", "doi": "10.1016/j.echo.2008.02.006" }, { "citation": "Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 1978;93(1):62-66. doi:10.1016/S0022-3476(78)80601-5", "doi": "10.1016/S0022-3476(78)80601-5" } ], "prefill_example": "https://heartcalc.doctorarichai.com/echo-z?ageY=10&ht=140&wt=35&unit=mm&v_ANN=18&v_ROOT=25&v_STJ=20&v_AAO=21&v_MVLAT=25&v_LVEDD=42&v_LVST=7&v_LVPWT=7&v_LMCA=3" }, { "id": "lv-mass", "name": "LV Mass and LVH", "url": "https://heartcalc.doctorarichai.com/lv-mass", "status": "verified", "group": "echo", "group_label": "Echo", "description": "PHN 2D LV mass, volume and wall Z scores, plus M-mode LV mass indexed to height^2.7 against the Khoury 2009 cutoffs.", "keywords": "lv mass lvh hypertrophy devereux khoury", "population": "Children 0 to 18 years. PHN 2D LV mass Z scores (Lopez 2017); LV mass/height^2.7 is compared with the Khoury 2009 Table 2 95th percentile for age band and sex (0 to 18 years).", "method_url": "https://heartcalc.doctorarichai.com/lv-mass#method", "inputs": [ { "name": "ageY", "label": "Age", "type": "number", "unit": "years", "min": 0, "required": true, "notes": null }, { "name": "sex", "label": "Sex", "type": "select", "unit": null, "options": [ { "value": "male", "label": "Male" }, { "value": "female", "label": "Female" } ], "required": true, "notes": null }, { "name": "ht", "label": "Height", "type": "number", "unit": "cm", "min": 0, "required": true, "notes": null }, { "name": "wt", "label": "Weight", "type": "number", "unit": "kg", "min": 0, "required": true, "notes": null }, { "name": "unit", "label": "Diameters, thicknesses and lengths entered in", "type": "radio", "unit": null, "options": [ { "value": "mm", "label": "mm" }, { "value": "cm", "label": "cm" } ], "required": true, "notes": "Required. Areas are always cm², mass g." }, { "name": "mode2d", "label": "Input", "type": "radio", "unit": null, "options": [ { "value": "meas", "label": "Areas and lengths" }, { "value": "mass", "label": "I have the 2D mass" } ], "default": "meas", "required": false, "notes": null }, { "name": "LVEDA", "label": "End-diastolic area, endocardial", "type": "number", "unit": "cm²", "min": 0, "required": false, "notes": null }, { "name": "LVEDAEPI", "label": "End-diastolic area, epicardial", "type": "number", "unit": "cm²", "min": 0, "required": false, "notes": null }, { "name": "LVEDL", "label": "LV length, endocardial", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "LVEDLEPI", "label": "LV length, epicardial", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "lvm2d", "label": "2D LV mass, area-length", "type": "number", "unit": "g", "min": 0, "required": false, "notes": null }, { "name": "LVEDD", "label": "LV end-diastolic diameter", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "LVST", "label": "Septal thickness, diastole", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "LVPWT", "label": "Posterior wall, diastole", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "ivs", "label": "IVSd", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "lvid", "label": "LVIDd", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "pw", "label": "LVPWd", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." } ], "input_notes": "mode2d=meas (default) uses the four 2D areas and lengths; mode2d=mass uses lvm2d. M-mode mass uses ivs, lvid and pw. Lengths follow the unit radio (mm or cm, no default).", "outputs": [ "PHN 2D LV mass, volume and wall Z scores", "Devereux M-mode LV mass and LV mass/height^2.7", "Khoury 2009 95th-quantile curve of LVM/height^2.7 by age and sex (0-18 y)" ], "sources": [ { "citation": "Lopez L, Colan S, Stylianou M, et al. Circ Cardiovasc Imaging 2017;10(11):e006979. doi:10.1161/CIRCIMAGING.117.006979", "doi": "10.1161/CIRCIMAGING.117.006979" }, { "citation": "Khoury PR, Mitsnefes M, Daniels SR, Kimball TR. Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr 2009;22(6):709-714. doi:10.1016/j.echo.2009.03.003", "doi": "10.1016/j.echo.2009.03.003" }, { "citation": "Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986;57(6):450-458. doi:10.1016/0002-9149(86)90771-x", "doi": "10.1016/0002-9149(86)90771-x" }, { "citation": "Schoenmaker NJ, van der Lee JH, Groothoff JW, et al. Low agreement between cardiologists diagnosing left ventricular hypertrophy in children with end-stage renal disease. BMC Nephrol 2013;14:170. doi:10.1186/1471-2369-14-170", "doi": "10.1186/1471-2369-14-170" }, { "citation": "Haycock GB, Schwartz GJ, Wisotsky DH. J Pediatr 1978;93(1):62-66. doi:10.1016/S0022-3476(78)80601-5", "doi": "10.1016/S0022-3476(78)80601-5" } ], "prefill_example": "https://heartcalc.doctorarichai.com/lv-mass?ageY=12&sex=male&ht=150&wt=40&unit=mm&LVEDA=14&LVEDAEPI=25&LVEDL=68&LVEDLEPI=76&LVST=9&LVPWT=9&LVEDD=44&ivs=9&lvid=44&pw=9" }, { "id": "aortic-root", "name": "Aortic Root and Ghent", "url": "https://heartcalc.doctorarichai.com/aortic-root", "status": "verified", "group": "echo", "group_label": "Echo", "description": "Aortic root Z scores (PHN, with Detroit alongside) and the revised Ghent systemic score and rules as a reference checklist.", "keywords": "aortic root sinus marfan ghent loeys z-score dilation", "population": "Children 0 to 18 years for the PHN aortic Z scores (Detroit alongside). The revised Ghent (Loeys 2010) systemic score and rules are a reference checklist; Marfan syndrome is diagnosed by clinicians with genetic evaluation, not by a score.", "method_url": "https://heartcalc.doctorarichai.com/aortic-root#method", "inputs": [ { "name": "ageY", "label": "Age", "type": "number", "unit": "years", "min": 0, "required": true, "notes": null }, { "name": "ht", "label": "Height", "type": "number", "unit": "cm", "min": 0, "required": true, "notes": null }, { "name": "wt", "label": "Weight", "type": "number", "unit": "kg", "min": 0, "required": true, "notes": null }, { "name": "unit", "label": "Aortic diameters entered in", "type": "radio", "unit": null, "options": [ { "value": "mm", "label": "mm" }, { "value": "cm", "label": "cm" } ], "required": true, "notes": "Required." }, { "name": "ANN", "label": "Aortic valve annulus", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "ROOT", "label": "Sinuses of Valsalva", "type": "number", "unit": null, "min": 0, "required": true, "notes": "Unit follows the unit choice on the page." }, { "name": "STJ", "label": "Sinotubular junction", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "AAO", "label": "Ascending aorta", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "aoSrc", "label": "Aortic root Z used for Ghent", "type": "radio", "unit": null, "options": [ { "value": "phn", "label": "PHN root Z above" }, { "value": "entered", "label": "Enter a Z" } ], "default": "phn", "required": false, "notes": null }, { "name": "aoZ", "label": "Aortic root Z score from another nomogram", "type": "number", "unit": "Z", "required": false, "notes": "Used when aoSrc is entered." }, { "name": "diss", "label": "Aortic root dissection (meets the aortic criterion whatever the Z; a dissection confined to the descending aorta does not count)", "type": "checkbox", "unit": null, "required": false, "notes": null }, { "name": "el", "label": "Ectopia lentis", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": null }, { "name": "fh", "label": "Family history of Marfan syndrome", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": "Relative independently diagnosed by these criteria." }, { "name": "fbn1", "label": "FBN1 testing", "type": "select", "unit": null, "options": [ { "value": "none", "label": "No pathogenic FBN1 variant, or not tested" }, { "value": "fbn1", "label": "Pathogenic (bona fide) FBN1 variant" }, { "value": "fbn1ao", "label": "FBN1 variant previously associated with aortic root aneurysm or dissection" } ], "default": "none", "required": false, "notes": null }, { "name": "wristThumb", "label": "Wrist and thumb signs", "type": "select", "unit": null, "options": [ { "value": "none", "label": "Neither (0)" }, { "value": "one", "label": "Wrist OR thumb sign (1)" }, { "value": "both", "label": "Wrist AND thumb sign (3)" } ], "required": false, "notes": null }, { "name": "pectus", "label": "Chest", "type": "select", "unit": null, "options": [ { "value": "none", "label": "Neither (0)" }, { "value": "excavatum", "label": "Pectus excavatum or chest asymmetry (1)" }, { "value": "carinatum", "label": "Pectus carinatum (2)" } ], "required": false, "notes": null }, { "name": "foot", "label": "Foot", "type": "select", "unit": null, "options": [ { "value": "none", "label": "Neither (0)" }, { "value": "flat", "label": "Plain flat foot (1)" }, { "value": "hindfoot", "label": "Hindfoot deformity (2)" } ], "required": false, "notes": null }, { "name": "pneumothorax", "label": "Spontaneous pneumothorax", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 2 points." }, { "name": "dural", "label": "Dural ectasia", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 2 points." }, { "name": "protrusio", "label": "Protrusio acetabuli", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 2 points." }, { "name": "usls", "label": "Reduced upper/lower segment AND increased arm span/height, without severe scoliosis", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 1 point." }, { "name": "scoliosis", "label": "Scoliosis or thoracolumbar kyphosis", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 1 point." }, { "name": "elbow", "label": "Reduced elbow extension (170° or less)", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 1 point." }, { "name": "facial", "label": "Facial features, at least 3 of 5 (dolichocephaly, enophthalmos, downslanting palpebral fissures, malar hypoplasia, retrognathia)", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 1 point." }, { "name": "striae", "label": "Skin striae (not explained by weight change or pregnancy)", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 1 point." }, { "name": "myopia", "label": "Myopia more than 3 diopters", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 1 point." }, { "name": "mvp", "label": "Mitral valve prolapse (all types)", "type": "checkbox", "unit": null, "required": false, "notes": "Ghent systemic feature, 1 point." } ], "input_notes": "Diameters follow the unit radio (mm or cm, no default). aoSrc=entered uses aoZ (another nomogram) for the Ghent rules. Systemic features are selects (wristThumb, pectus, foot) and checkboxes.", "outputs": [ "Annulus, sinus, STJ and ascending aorta Z scores with normal ranges (PHN; Detroit comparison)", "Revised Ghent systemic score (out of 20)", "Which Loeys 2010 rules the entries meet, with caveats" ], "sources": [ { "citation": "Lopez L, Colan S, Stylianou M, et al. Circ Cardiovasc Imaging 2017;10(11):e006979. doi:10.1161/CIRCIMAGING.117.006979", "doi": "10.1161/CIRCIMAGING.117.006979" }, { "citation": "Pettersen MD, Du W, Skeens ME, Humes RA. J Am Soc Echocardiogr 2008;21(8):922-934. doi:10.1016/j.echo.2008.02.006", "doi": "10.1016/j.echo.2008.02.006" }, { "citation": "Lopez L, et al. Pediatric Heart Network echocardiographic Z scores: comparison to other published models. J Am Soc Echocardiogr 2021;34(2):185-192. doi:10.1016/j.echo.2020.09.019", "doi": "10.1016/j.echo.2020.09.019" }, { "citation": "Loeys BL, Dietz HC, Braverman AC, et al. The revised Ghent nosology for the Marfan syndrome. J Med Genet 2010;47(7):476-485. doi:10.1136/jmg.2009.072785", "doi": "10.1136/jmg.2009.072785" }, { "citation": "Roman MJ, Devereux RB, Kramer-Fox R, O’Loughlin J. Two-dimensional echocardiographic aortic root dimensions in normal children and adults. Am J Cardiol 1989;64(8):507-512 (the nomogram Loeys 2010 cites for leading-edge, diastolic measurements; not implemented here). doi:10.1016/0002-9149(89)90430-X", "doi": "10.1016/0002-9149(89)90430-X" }, { "citation": "Isselbacher EM, Preventza O, Hamilton Black J 3rd, et al. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease. Circulation 2022;146(24):e334-e482. doi:10.1161/CIR.0000000000001106", "doi": "10.1161/CIR.0000000000001106" }, { "citation": "Mazzolai L, Teixido-Tura G, Lanzi S, et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J 2024;45(36):3538-3700. doi:10.1093/eurheartj/ehae179", "doi": "10.1093/eurheartj/ehae179" }, { "citation": "Morris SA, Flyer JN, Yetman AT, et al. Cardiovascular management of aortopathy in children: a scientific statement from the American Heart Association. Circulation 2024;150(11):e228-e254. doi:10.1161/CIR.0000000000001265", "doi": "10.1161/CIR.0000000000001265" }, { "citation": "Haycock GB, Schwartz GJ, Wisotsky DH. J Pediatr 1978;93(1):62-66. doi:10.1016/S0022-3476(78)80601-5", "doi": "10.1016/S0022-3476(78)80601-5" } ], "prefill_example": "https://heartcalc.doctorarichai.com/aortic-root?ageY=14&ht=165&wt=50&unit=mm&ANN=22&ROOT=34&STJ=27&AAO=27&el=no&fh=no&wristThumb=both&pectus=excavatum&foot=flat&myopia=1&mvp=1" }, { "id": "turner", "name": "Turner Syndrome Aortic Z-Scores", "url": "https://heartcalc.doctorarichai.com/turner", "status": "verified", "group": "echo", "group_label": "Echo", "description": "Aortic size compared with healthy girls and women with Turner syndrome (Quezada 2015), with the aortic size index.", "keywords": "turner syndrome 45x monosomy x aorta aortic dilation dissection z-score quezada aortic size index asi bicuspid coarctation ascending aorta", "population": "Girls and women with Turner syndrome, 2 to 70 years (Quezada 2015 reference: healthy subjects with Turner syndrome, bicuspid aortic valve excluded from the equations). Not for other populations.", "method_url": "https://heartcalc.doctorarichai.com/turner#method", "inputs": [ { "name": "ageY", "label": "Age", "type": "number", "unit": "years", "min": 0, "required": true, "notes": null }, { "name": "ht", "label": "Height", "type": "number", "unit": "cm", "min": 0, "required": true, "notes": null }, { "name": "wt", "label": "Weight", "type": "number", "unit": "kg", "min": 0, "required": true, "notes": null }, { "name": "bav", "label": "Aortic valve", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "Trileaflet" }, { "value": "yes", "label": "Bicuspid" } ], "required": true, "notes": "Required. The reference excludes bicuspid valves. no = trileaflet, yes = bicuspid (the reference excludes BAV; results carry a caution)." }, { "name": "unit", "label": "Diameters entered in", "type": "radio", "unit": null, "options": [ { "value": "mm", "label": "mm" }, { "value": "cm", "label": "cm" } ], "required": true, "notes": "Required." }, { "name": "ANN", "label": "Aortic valve annulus", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "AR", "label": "Aortic root (sinuses)", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "STJ", "label": "Sinotubular junction", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "AAO", "label": "Ascending aorta", "type": "number", "unit": null, "min": 0, "required": true, "notes": "Unit follows the unit choice on the page." }, { "name": "PTA", "label": "Proximal transverse arch", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "DTA", "label": "Distal transverse arch", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "ISTH", "label": "Aortic isthmus", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "DAO", "label": "Descending aorta", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." } ], "input_notes": "Diameters follow the unit radio (mm or cm, no default). Enter any of ANN, AR, STJ, AAO, PTA, DTA, ISTH, DAO.", "outputs": [ "Turner-specific Z scores for 8 aortic levels (annulus to descending aorta), with the expected diameter and the Z +2 diameter", "Aortic size index (ascending aorta / BSA) with the age caveat" ], "sources": [ { "citation": "Quezada E, Lapidus J, Shaughnessy R, Chen Z, Silberbach M. Aortic dimensions in Turner syndrome. Am J Med Genet A 2015;167A:2527–2532. doi:10.1002/ajmg.a.37208", "doi": "10.1002/ajmg.a.37208" }, { "citation": "Gravholt CH, Andersen NH, Christin-Maitre S, et al. Clinical practice guidelines for the care of girls and women with Turner syndrome. Eur J Endocrinol 2024;190(6):G53–G151. doi:10.1093/ejendo/lvae050", "doi": "10.1093/ejendo/lvae050" }, { "citation": "Isselbacher EM, Preventza O, Hamilton Black J 3rd, et al. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease. Circulation 2022;146(24):e334–e482. doi:10.1161/CIR.0000000000001106", "doi": "10.1161/CIR.0000000000001106" }, { "citation": "Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease. Circulation 2019;139(14):e698–e800. doi:10.1161/CIR.0000000000000603", "doi": "10.1161/CIR.0000000000000603" } ], "prefill_example": "https://heartcalc.doctorarichai.com/turner?ageY=14&ht=145&wt=42&bav=no&unit=mm&AR=27&STJ=22&AAO=25" }, { "id": "kawasaki", "name": "Kawasaki Coronary Z-Scores", "url": "https://heartcalc.doctorarichai.com/kawasaki", "status": "verified", "group": "echo", "group_label": "Echo", "description": "Coronary artery z scores from four published models side by side, with the AHA 2024 classification and risk level on Boston z, its long-term management (Table 2), a model-disagreement flag and the Son 2019 aneurysm risk score.", "keywords": "kawasaki coronary aneurysm z-score aha risk level management mccrindle boston kobayashi son", "population": "Children with Kawasaki disease, 0 to 18 years. The AHA 2024 classification and risk level use Boston (McCrindle 2007) z, on which the AHA classification is based; PHN and Kobayashi (verified) and Dallaire (unverified) are shown alongside with a disagreement flag. The risk level needs the maximum z ever recorded (entered, or this echo answered as the highest so far) and applies once coronary dimensions are stable or improving. The Son 2019 risk score applies to the baseline echo (before IVIG, or less than 2 days after) in a North American population.", "method_url": "https://heartcalc.doctorarichai.com/kawasaki#method", "inputs": [ { "name": "age", "label": "Age at this echo", "type": "number", "unit": null, "min": 0, "required": true, "notes": "Unit set by ageUnit." }, { "name": "ageUnit", "label": "Age unit", "type": "radio", "unit": null, "options": [ { "value": "months", "label": "Months" }, { "value": "years", "label": "Years" } ], "required": true, "notes": null }, { "name": "sex", "label": "Sex", "type": "radio", "unit": null, "options": [ { "value": "male", "label": "Male" }, { "value": "female", "label": "Female" } ], "required": true, "notes": "Kobayashi z is sex-specific." }, { "name": "wt", "label": "Weight", "type": "number", "unit": "kg", "min": 0, "required": true, "notes": null }, { "name": "ht", "label": "Height", "type": "number", "unit": "cm", "min": 0, "required": true, "notes": null }, { "name": "dUnit", "label": "Diameter unit", "type": "radio", "unit": null, "options": [ { "value": "mm", "label": "mm" }, { "value": "cm", "label": "cm" } ], "required": true, "notes": "Required: a cm/mm slip is a 10× error." }, { "name": "dLMCA", "label": "LMCA", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "dLAD", "label": "Proximal LAD", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "dRCA", "label": "Proximal RCA", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "dLCx", "label": "Proximal LCx", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Optional." }, { "name": "rlMode", "label": "z scores from", "type": "radio", "unit": null, "options": [ { "value": "echo", "label": "This echo" }, { "value": "manual", "label": "Enter z scores" } ], "default": "echo", "required": false, "notes": "echo = risk level from this echo (Boston z); manual = from maxZ, max8, curZ, cur8 entered by hand (no patient inputs needed)." }, { "name": "isMax", "label": "Is this echo the highest z so far?", "type": "radio", "unit": null, "options": [ { "value": "yes", "label": "Yes" }, { "value": "no", "label": "No, enter the maximum" } ], "required": false, "notes": "Required for a level from this echo. Echo mode, required for a level: yes = this echo is the highest z so far; no = enter maxZ." }, { "name": "maxZ", "label": "Maximum Boston z ever, any branch", "type": "number", "unit": "Z", "required": false, "notes": "Manual mode, or echo mode when isMax is no." }, { "name": "max8", "label": "Any study ≥8 mm?", "type": "radio", "unit": null, "options": [ { "value": "yes", "label": "Yes" }, { "value": "no", "label": "No" } ], "required": false, "notes": "Internal diameter, any branch. yes/no: any study showed an internal diameter of 8 mm or more; yes makes the maximum large or giant (needed unless a z is 10 or more or an artery on this echo is 8 mm or more)." }, { "name": "curZ", "label": "Current Boston z, highest branch", "type": "number", "unit": "Z", "required": false, "notes": "Manual mode only." }, { "name": "cur8", "label": "Current diameter ≥8 mm?", "type": "radio", "unit": null, "options": [ { "value": "yes", "label": "Yes" }, { "value": "no", "label": "No" } ], "required": false, "notes": "Internal diameter, any branch. yes/no: current internal diameter 8 mm or more (manual mode; needed unless curZ is 10 or more)." }, { "name": "baseline", "label": "Baseline echo?", "type": "radio", "unit": null, "options": [ { "value": "yes", "label": "Yes" }, { "value": "no", "label": "No" } ], "required": false, "notes": "Before IVIG, or <2 days after IVIG." }, { "name": "asian", "label": "Asian race reported", "type": "radio", "unit": null, "options": [ { "value": "yes", "label": "Yes" }, { "value": "no", "label": "No" } ], "required": false, "notes": "Sole or mixed (one or both parents)" }, { "name": "crp", "label": "Baseline CRP", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "crpUnit", "label": "CRP unit", "type": "radio", "unit": null, "options": [ { "value": "mg/dL", "label": "mg/dL" }, { "value": "mg/L", "label": "mg/L" } ], "required": false, "notes": "13 mg/dL = 130 mg/L." } ], "input_notes": "Every unit is explicit (ageUnit, dUnit, crpUnit; nothing pre-selected). Enter at least one coronary diameter (LMCA, LAD or RCA for the AHA classification: Boston has no LCx equation). The risk level uses rlMode (default echo) with isMax, maxZ and max8, or maxZ, max8, curZ and cur8 in manual mode. The Son score needs baseline, asian and crp.", "outputs": [ "Coronary z scores (LMCA, LAD, RCA, LCx) from PHN, Kobayashi, Boston and Dallaire", "AHA 2024 z-score classification per artery, including the 8 mm rule (Boston z drives the headline)", "AHA 2024 risk level (1 to 5.4) with its long-term management from Table 2, from this echo or from z scores entered by hand", "Model-disagreement flag", "Son 2019 aneurysm risk score" ], "sources": [ { "citation": "Lopez L, Colan S, Stylianou M, et al. Relationship of echocardiographic Z scores adjusted for body surface area to age, sex, race, and ethnicity: the Pediatric Heart Network Normal Echocardiogram Database. Circ Cardiovasc Imaging 2017;10(11):e006979. doi:10.1161/CIRCIMAGING.117.006979", "doi": "10.1161/CIRCIMAGING.117.006979" }, { "citation": "Kobayashi T, Fuse S, Sakamoto N, et al. A new Z score curve of the coronary arterial internal diameter using the lambda-mu-sigma method in a pediatric population. J Am Soc Echocardiogr 2016;29(8):794-801.e29. doi:10.1016/j.echo.2016.03.017", "doi": "10.1016/j.echo.2016.03.017" }, { "citation": "McCrindle BW, Li JS, Minich LL, et al. Coronary artery involvement in children with Kawasaki disease: risk factors from analysis of serial normalized measurements. Circulation 2007;116(2):174-179. doi:10.1161/CIRCULATIONAHA.107.690875", "doi": "10.1161/CIRCULATIONAHA.107.690875" }, { "citation": "Dallaire F, Dahdah N. New equations and a critical appraisal of coronary artery Z scores in healthy children. J Am Soc Echocardiogr 2011;24(1):60-74. doi:10.1016/j.echo.2010.10.004", "doi": "10.1016/j.echo.2010.10.004" }, { "citation": "McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation 2017;135(17):e927-e999. doi:10.1161/CIR.0000000000000484", "doi": "10.1161/CIR.0000000000000484" }, { "citation": "Jone PN, Tremoulet A, Choueiter N, Dominguez SR, Harahsheh AS, Mitani Y, Zimmerman M, Lin MT, Friedman KG; on behalf of the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular and Stroke Nursing; Council on Cardiovascular Radiology and Intervention; and Council on Clinical Cardiology. Update on diagnosis and management of Kawasaki disease: a scientific statement from the American Heart Association. Circulation 2024;150(23):e481-e500. doi:10.1161/CIR.0000000000001295", "doi": "10.1161/CIR.0000000000001295" }, { "citation": "Correction to: Update on diagnosis and management of Kawasaki disease. Circulation 2025;151(8):e677-e679. doi:10.1161/CIR.0000000000001313", "doi": "10.1161/CIR.0000000000001313" }, { "citation": "Correction to: Update on diagnosis and management of Kawasaki disease. Circulation 2025;151(13):e863. doi:10.1161/CIR.0000000000001324", "doi": "10.1161/CIR.0000000000001324" }, { "citation": "Son MBF, Gauvreau K, Tremoulet AH, et al. Risk model development and validation for prediction of coronary artery aneurysms in Kawasaki disease in a North American population. J Am Heart Assoc 2019;8(11):e011319. doi:10.1161/JAHA.118.011319", "doi": "10.1161/JAHA.118.011319" }, { "citation": "Kim SH, et al. Diagnosis of coronary artery abnormalities in Kawasaki disease: recent guidelines and z score systems. Clin Exp Pediatr 2022;65(9):430-438. doi:10.3345/cep.2021.01459", "doi": "10.3345/cep.2021.01459" }, { "citation": "Robinson DL, Ware AL, Sauer MC, et al. Implications of changing z-score models for coronary artery dimensions in Kawasaki disease. Pediatr Cardiol 2021;42(2):432-441. doi:10.1007/s00246-020-02501-0", "doi": "10.1007/s00246-020-02501-0" }, { "citation": "Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 1978;93(1):62-66. doi:10.1016/s0022-3476(78)80601-5", "doi": "10.1016/s0022-3476(78)80601-5" } ], "prefill_example": "https://heartcalc.doctorarichai.com/kawasaki?age=3&ageUnit=years&sex=male&wt=14&ht=95&dUnit=mm&dLMCA=2.6&dLAD=2.4&dRCA=2.5&rlMode=echo&isMax=no&maxZ=6.1&max8=no&baseline=yes&asian=no&crp=15&crpUnit=mg%2FdL" }, { "id": "ph-echo", "name": "PH Echo Estimator", "url": "https://heartcalc.doctorarichai.com/ph-echo", "status": "experimental", "group": "echo", "group_label": "Echo", "description": "Pediatric pulmonary hypertension echo screening markers: RVSP, PA acceleration time, eccentricity index and TAPSE.", "keywords": "pulmonary hypertension rvsp tr jet paat eccentricity index tapse", "population": "Children being screened for pulmonary hypertension by echo. Levy 2016 PAAT equations: 1 to 18 years and heart rate 55 to 150 bpm, with exclusions (single ventricle, RV outflow obstruction, and others) asked on the page. Screening estimates, not a diagnosis: catheterization is recommended before PAH-targeted therapy.", "method_url": "https://heartcalc.doctorarichai.com/ph-echo#method", "inputs": [ { "name": "ageY", "label": "Age", "type": "number", "unit": "years", "min": 0, "required": false, "notes": "Example: 0.5 = 6 mo." }, { "name": "sex", "label": "Sex", "type": "radio", "unit": null, "options": [ { "value": "female", "label": "Female" }, { "value": "male", "label": "Male" } ], "required": false, "notes": "For the PAAT z-score. female or male; used for the PAAT z-score." }, { "name": "hr", "label": "Heart rate", "type": "number", "unit": "bpm", "required": false, "notes": null }, { "name": "sbp", "label": "Systolic BP", "type": "number", "unit": "mmHg", "required": false, "notes": "Optional." }, { "name": "xSv", "label": "Single ventricle physiology", "type": "checkbox", "unit": null, "required": false, "notes": null }, { "name": "xRvoto", "label": "RV outflow or pulmonary valve obstruction", "type": "checkbox", "unit": null, "required": false, "notes": null }, { "name": "xPi", "label": "Pulmonary insufficiency", "type": "checkbox", "unit": null, "required": false, "notes": null }, { "name": "xLhd", "label": "Left heart disease", "type": "checkbox", "unit": null, "required": false, "notes": null }, { "name": "xArrh", "label": "Arrhythmia", "type": "checkbox", "unit": null, "required": false, "notes": null }, { "name": "xVasod", "label": "On pulmonary vasodilators", "type": "checkbox", "unit": null, "required": false, "notes": null }, { "name": "xSeptal", "label": "Prior septal surgery (VSD or AVSD repair)", "type": "checkbox", "unit": null, "required": false, "notes": null }, { "name": "xCond", "label": "Pacing or bundle branch block", "type": "checkbox", "unit": null, "required": false, "notes": null }, { "name": "trV", "label": "Peak TR velocity", "type": "number", "unit": null, "required": false, "notes": "Unit set by trUnit." }, { "name": "trUnit", "label": "Velocity unit", "type": "radio", "unit": null, "options": [ { "value": "m/s", "label": "m/s" }, { "value": "cm/s", "label": "cm/s" } ], "required": false, "notes": "Required: no default." }, { "name": "rap", "label": "RA pressure you assume", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "paat", "label": "PAAT", "type": "number", "unit": "ms", "required": false, "notes": null }, { "name": "rvet", "label": "RV ejection time", "type": "number", "unit": "ms", "required": false, "notes": "Optional." }, { "name": "eiMode", "label": "Enter as", "type": "radio", "unit": null, "options": [ { "value": "diam", "label": "Two diameters" }, { "value": "direct", "label": "EI value" } ], "required": false, "notes": null }, { "name": "dPar", "label": "LV diameter parallel to septum", "type": "number", "unit": "mm", "required": false, "notes": "Used when eiMode is diam." }, { "name": "dPerp", "label": "LV diameter perpendicular to septum", "type": "number", "unit": "mm", "required": false, "notes": "Used when eiMode is diam." }, { "name": "eis", "label": "End-systolic EI", "type": "number", "unit": "ratio", "required": false, "notes": "Used when eiMode is direct." }, { "name": "eim", "label": "Maximal EI", "type": "number", "unit": "ratio", "required": false, "notes": "Optional (Burkett)." }, { "name": "tapse", "label": "TAPSE", "type": "number", "unit": null, "required": false, "notes": "Unit set by tapseUnit." }, { "name": "tapseUnit", "label": "Unit", "type": "radio", "unit": null, "options": [ { "value": "mm", "label": "mm" }, { "value": "cm", "label": "cm" } ], "required": false, "notes": "Required: no default." } ], "input_notes": "Each marker is reported on its own: TR jet (trV with trUnit, no default, and rap), PAAT (with ageY and hr; sex for the z-score), eccentricity index (eiMode: two diameters or the EI value), TAPSE (with tapseUnit, no default; ageY for the age band). The x* checkboxes are conditions: Levy exclusions; xSv and xRvoto also withhold the PAAT z-score, and xSv the TAPSE band.", "outputs": [ "RVSP from the TR jet with an explicit RA pressure", "Levy 2016 estimates of mPAP, PVR and PVRi from PAAT", "PAAT z-score for age and sex (Koestenberger 2017)", "End-systolic eccentricity index against published cut-offs", "TAPSE band within its age group (Koestenberger 2009)" ], "sources": [ { "citation": "Abman SH, Hansmann G, Archer SL, et al. Pediatric Pulmonary Hypertension: Guidelines From the American Heart Association and American Thoracic Society. Circulation 2015;132(21):2037-2099. doi:10.1161/CIR.0000000000000329", "doi": "10.1161/CIR.0000000000000329" }, { "citation": "Ivy D, Rosenzweig EB, Abman SH, et al. Embracing the challenges of neonatal and paediatric pulmonary hypertension. Eur Respir J 2024;64(4):2401345. doi:10.1183/13993003.01345-2024", "doi": "10.1183/13993003.01345-2024" }, { "citation": "Schweintzger S, Kurath-Koller S, Burmas A, et al. Normal echocardiographic reference values of the right ventricular to left ventricular endsystolic diameter ratio and the left ventricular endsystolic eccentricity index in healthy children and in children with pulmonary hypertension. Front Cardiovasc Med 2022;9:950765. doi:10.3389/fcvm.2022.950765", "doi": "10.3389/fcvm.2022.950765" }, { "citation": "Yock PG, Popp RL. Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation. Circulation 1984;70(4):657-662. doi:10.1161/01.cir.70.4.657", "doi": "10.1161/01.cir.70.4.657" }, { "citation": "Levy PT, Patel MD, Groh G, et al. Pulmonary Artery Acceleration Time Provides a Reliable Estimate of Invasive Pulmonary Hemodynamics in Children. J Am Soc Echocardiogr 2016;29(11):1056-1065. doi:10.1016/j.echo.2016.08.013", "doi": "10.1016/j.echo.2016.08.013" }, { "citation": "Koestenberger M, Grangl G, Avian A, et al. Normal Reference Values and z Scores of the Pulmonary Artery Acceleration Time in Children and Its Importance for the Assessment of Pulmonary Hypertension. Circ Cardiovasc Imaging 2017;10(1):e005336. doi:10.1161/CIRCIMAGING.116.005336", "doi": "10.1161/CIRCIMAGING.116.005336" }, { "citation": "Ryan T, Petrovic O, Dillon JC, et al. An echocardiographic index for separation of right ventricular volume and pressure overload. J Am Coll Cardiol 1985;5(4):918-927. doi:10.1016/s0735-1097(85)80433-2", "doi": "10.1016/s0735-1097(85)80433-2" }, { "citation": "Burkett DA, Patel SS, Mertens L, Friedberg MK, Ivy DD. Relationship Between Left Ventricular Geometry and Invasive Hemodynamics in Pediatric Pulmonary Hypertension. Circ Cardiovasc Imaging 2020;13(5):e009825. doi:10.1161/CIRCIMAGING.119.009825", "doi": "10.1161/CIRCIMAGING.119.009825" }, { "citation": "Abraham S, Weismann CG. Left Ventricular End-Systolic Eccentricity Index for Assessment of Pulmonary Hypertension in Infants. Echocardiography 2016;33(6):910-915. doi:10.1111/echo.13171", "doi": "10.1111/echo.13171" }, { "citation": "Averin K, Michelfelder E, Sticka J, Cash M, Hirsch R. Changes in Ventricular Geometry Predict Severity of Right Ventricular Hypertension. Pediatr Cardiol 2016;37(3):575-581. doi:10.1007/s00246-015-1317-z", "doi": "10.1007/s00246-015-1317-z" }, { "citation": "Simpkin CT, DeLima M, MacBeth M, et al. Eccentricity Index Is Associated With Pulmonary Arterial Hypertension in Children After Repair of Complete Atrioventricular Septal Defects. Echocardiography 2026;43(4):e70451. doi:10.1111/echo.70451", "doi": "10.1111/echo.70451" }, { "citation": "Hansmann G, Koestenberger M, Alastalo TP, et al. 2019 updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension: the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). J Heart Lung Transplant 2019;38(9):879-901. doi:10.1016/j.healun.2019.06.022", "doi": "10.1016/j.healun.2019.06.022" }, { "citation": "Koestenberger M, Ravekes W, Everett AD, et al. Right ventricular function in infants, children and adolescents: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 640 healthy patients and calculation of z score values. J Am Soc Echocardiogr 2009;22(6):715-719. doi:10.1016/j.echo.2009.03.026", "doi": "10.1016/j.echo.2009.03.026" } ], "prefill_example": "https://heartcalc.doctorarichai.com/ph-echo?ageY=6&sex=male&hr=100&sbp=100&trV=3.2&trUnit=m%2Fs&rap=5&paat=72&rvet=260&eiMode=diam&dPar=36&dPerp=28&tapse=17&tapseUnit=mm" }, { "id": "cicu", "name": "CICU Severity Panel", "url": "https://heartcalc.doctorarichai.com/cicu", "status": "verified", "group": "icu", "group_label": "NICU & CICU", "description": "Vasoactive-inotropic score, vasoactive-ventilation-renal score, oxygenation index and oxygen saturation index after cardiac surgery.", "keywords": "vis vasoactive inotropic score vvr oxygenation index osi ventilation icu", "population": "Children in the cardiac ICU after cardiac surgery. The VIS outcome groups (Gaies) were derived in infants under 1 year after cardiopulmonary bypass, in the first 48 hours; VVR in children after cardiac surgery; OI and OSI bands follow PALICC-2 and are withheld for intracardiac mixing or cyanotic lesions.", "method_url": "https://heartcalc.doctorarichai.com/cicu#method", "inputs": [ { "name": "dopa", "label": "Dopamine", "type": "number", "unit": "mcg/kg/min", "min": 0, "required": false, "notes": null }, { "name": "dobu", "label": "Dobutamine", "type": "number", "unit": "mcg/kg/min", "min": 0, "required": false, "notes": null }, { "name": "epi", "label": "Epinephrine", "type": "number", "unit": "mcg/kg/min", "min": 0, "required": false, "notes": null }, { "name": "norepi", "label": "Norepinephrine", "type": "number", "unit": "mcg/kg/min", "min": 0, "required": false, "notes": null }, { "name": "milri", "label": "Milrinone", "type": "number", "unit": "mcg/kg/min", "min": 0, "required": false, "notes": null }, { "name": "vaso", "label": "Vasopressin", "type": "number", "unit": null, "min": 0, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "vasoUnit", "label": "Vasopressin unit", "type": "radio", "unit": null, "options": [ { "value": "U", "label": "units/kg/min" }, { "value": "mU", "label": "milliunits/kg/min" } ], "required": false, "notes": "No default. Units/kg/min and milliunits/kg/min differ 1000-fold." }, { "name": "population", "label": "Patient", "type": "radio", "unit": null, "options": [ { "value": "infantCpb", "label": "Infant <1 y, after CPB surgery" }, { "value": "other", "label": "Other" } ], "required": false, "notes": "The VIS-outcome studies enrolled infants after surgery with bypass." }, { "name": "window", "label": "Window after CICU admission", "type": "radio", "unit": null, "options": [ { "value": "h0_24", "label": "0–24 h" }, { "value": "h24_48", "label": "24–48 h" }, { "value": "other", "label": "Later" } ], "required": false, "notes": "Gaies groups use the maximum VIS in each window." }, { "name": "vent", "label": "Ventilation status", "type": "radio", "unit": null, "options": [ { "value": "conv", "label": "Intubated, conventional" }, { "value": "hfov", "label": "Intubated, HFOV" }, { "value": "extubated", "label": "Extubated" } ], "required": false, "notes": null }, { "name": "rr", "label": "Ventilator rate", "type": "number", "unit": "breaths/min", "required": false, "notes": null }, { "name": "pip", "label": "PIP", "type": "number", "unit": "cmH₂O", "required": false, "notes": null }, { "name": "peep", "label": "PEEP", "type": "number", "unit": "cmH₂O", "required": false, "notes": null }, { "name": "paco2", "label": "PaCO₂", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "map", "label": "Mean airway pressure", "type": "number", "unit": "cmH₂O", "required": false, "notes": null }, { "name": "fio2", "label": "FiO₂", "type": "number", "unit": "%", "required": false, "notes": "Hint: 21 to 100." }, { "name": "pao2", "label": "PaO₂", "type": "number", "unit": "mmHg", "required": false, "notes": null }, { "name": "spo2", "label": "SpO₂", "type": "number", "unit": "%", "required": false, "notes": null }, { "name": "mixing", "label": "Intracardiac mixing or cyanotic lesion?", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": "PALICC-2 does not stratify cyanotic heart disease by OI or OSI." }, { "name": "crUnit", "label": "Creatinine unit", "type": "radio", "unit": null, "options": [ { "value": "mgdl", "label": "mg/dL" }, { "value": "umol", "label": "µmol/L" } ], "required": false, "notes": "No default. mg/dL and µmol/L differ about 88-fold." }, { "name": "crBase", "label": "Baseline (pre-op) creatinine", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice on the page." }, { "name": "crNow", "label": "Current creatinine", "type": "number", "unit": null, "required": false, "notes": "Unit follows the unit choice on the page." } ], "input_notes": "Blank infusions count as not running. Vasopressin needs vasoUnit (no default). VVR needs vent and the ventilator fields plus creatinine with crUnit (no default). OI needs map, fio2 and pao2; OSI uses spo2 (97% or lower).", "outputs": [ "Vasoactive-inotropic score (VIS) and Gaies outcome group", "Ventilation index and vasoactive-ventilation-renal (VVR) score", "Oxygenation index (OI) and oxygen saturation index (OSI) with PALICC-2 bands" ], "sources": [ { "citation": "Gaies MG, Gurney JG, Yen AH, et al. Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass. Pediatr Crit Care Med 2010;11(2):234-238. doi:10.1097/PCC.0b013e3181b806fc", "doi": "10.1097/PCC.0b013e3181b806fc" }, { "citation": "Gaies MG, Jeffries HE, Niebler RA, et al. Vasoactive-inotropic score is associated with outcome after infant cardiac surgery: an analysis from the Pediatric Cardiac Critical Care Consortium and Virtual PICU System Registries. Pediatr Crit Care Med 2014;15(6):529-537. doi:10.1097/PCC.0000000000000153", "doi": "10.1097/PCC.0000000000000153" }, { "citation": "Miletic KG, Spiering TJ, Delius RE, Walters HL, Mastropietro CW. Use of a novel vasoactive-ventilation-renal score to predict outcomes after paediatric cardiac surgery. Interact Cardiovasc Thorac Surg 2015;20(3):289-295. doi:10.1093/icvts/ivu409", "doi": "10.1093/icvts/ivu409" }, { "citation": "Miletic KG, Delius RE, Walters HL, Mastropietro CW. Prospective validation of a novel vasoactive-ventilation-renal score as a predictor of outcomes after pediatric cardiac surgery. Ann Thorac Surg 2016;101(4):1558-1563. doi:10.1016/j.athoracsur.2015.11.006", "doi": "10.1016/j.athoracsur.2015.11.006" }, { "citation": "Emeriaud G, López-Fernández YM, Iyer NP, et al. Executive summary of the Second International Guidelines for the Diagnosis and Management of Pediatric Acute Respiratory Distress Syndrome (PALICC-2). Pediatr Crit Care Med 2023;24(2):143-168. doi:10.1097/PCC.0000000000003147", "doi": "10.1097/PCC.0000000000003147" } ], "prefill_example": "https://heartcalc.doctorarichai.com/cicu?dopa=5&epi=0.05&milri=0.5&vaso=0.5&vasoUnit=mU&population=infantCpb&window=h0_24&vent=conv&rr=20&pip=25&peep=5&paco2=45&map=12&fio2=50&pao2=80&spo2=95&mixing=no&crUnit=mgdl&crBase=0.3&crNow=0.6" }, { "id": "sv-o2", "name": "Single-Ventricle O2 Explorer", "url": "https://heartcalc.doctorarichai.com/sv-o2", "status": "experimental", "group": "icu", "group_label": "NICU & CICU", "description": "Educational model of a parallel circulation: Qp:Qs from saturations and systemic oxygen delivery across Qp:Qs, after Barnea 1994.", "keywords": "single ventricle qp:qs oxygen delivery barnea norwood parallel circulation", "population": "Educational model of a single-ventricle parallel circulation (for example before or after a Norwood or shunt), after Barnea 1994: steady state, complete mixing, dissolved O2 ignored. A teaching tool, not for patient management.", "method_url": "https://heartcalc.doctorarichai.com/sv-o2#method", "inputs": [ { "name": "sao2", "label": "Arterial (aortic) SaO₂", "type": "number", "unit": "%", "required": true, "notes": null }, { "name": "svo2", "label": "Systemic venous (SVC) SvO₂", "type": "number", "unit": "%", "required": true, "notes": null }, { "name": "spv", "label": "Pulmonary venous SpvO₂", "type": "number", "unit": "%", "required": false, "notes": "Assumed; drives every result." }, { "name": "hb", "label": "Haemoglobin", "type": "number", "unit": "g/dL", "required": false, "notes": null }, { "name": "vo2", "label": "VO₂ index", "type": "number", "unit": "mL/min/m²", "required": false, "notes": null }, { "name": "qt", "label": "Total output Qp + Qs", "type": "number", "unit": "L/min/m²", "required": false, "notes": null } ], "input_notes": "sao2, svo2 and spv (assumed pulmonary venous saturation) give the bedside Qp:Qs. hb, vo2 and qt (total output) draw the curves.", "outputs": [ "Bedside Qp:Qs from saturations", "Systemic oxygen delivery, SaO2 and SvO2 across Qp:Qs", "Optimal Qp:Qs and the range where delivery exceeds VO2" ], "sources": [ { "citation": "Barnea O, Austin EH, Richman B, Santamore WP. Balancing the circulation: theoretic optimization of pulmonary/systemic flow ratio in hypoplastic left heart syndrome. J Am Coll Cardiol 1994;24(5):1376-1381. doi:10.1016/0735-1097(94)90123-6", "doi": "10.1016/0735-1097(94)90123-6" } ], "prefill_example": "https://heartcalc.doctorarichai.com/sv-o2?sao2=80&svo2=55&spv=98&hb=15&vo2=150&qt=7.03" }, { "id": "bp", "name": "Pediatric Blood Pressure", "url": "https://heartcalc.doctorarichai.com/bp", "status": "verified", "group": "clinic", "group_label": "Clinic", "description": "AAP 2017 category and stage for one reading from the child's table percentiles (1 to <13 y) or fixed thresholds (13 to <18 y), with a four-limb gradient helper.", "keywords": "blood pressure hypertension aap 2017 percentile four limb coarctation", "population": "Children and adolescents 1 to under 18 years (AAP 2017). Ages 1 to under 13 need the 90th and 95th percentile values read from the guideline tables (Tables 4 and 5) for the child's age and height percentile; ages 13 to under 18 use fixed thresholds. Under 1 year: use Neonatal Blood Pressure. Classifies one reading; hypertension needs repeated, auscultatory-confirmed readings.", "method_url": "https://heartcalc.doctorarichai.com/bp#method", "inputs": [ { "name": "ageY", "label": "Age", "type": "number", "unit": "years", "min": 0, "required": true, "notes": null }, { "name": "sex", "label": "Sex", "type": "select", "unit": null, "options": [ { "value": "male", "label": "Male" }, { "value": "female", "label": "Female" } ], "required": true, "notes": null }, { "name": "sbp", "label": "Systolic", "type": "number", "unit": "mm Hg", "required": true, "notes": null }, { "name": "dbp", "label": "Diastolic", "type": "number", "unit": "mm Hg", "required": true, "notes": null }, { "name": "sbp90", "label": "SBP 90th percentile", "type": "number", "unit": "mm Hg", "required": false, "notes": null }, { "name": "sbp95", "label": "SBP 95th percentile", "type": "number", "unit": "mm Hg", "required": false, "notes": null }, { "name": "dbp90", "label": "DBP 90th percentile", "type": "number", "unit": "mm Hg", "required": false, "notes": null }, { "name": "dbp95", "label": "DBP 95th percentile", "type": "number", "unit": "mm Hg", "required": false, "notes": null }, { "name": "ra", "label": "Right arm", "type": "number", "unit": "mm Hg", "required": false, "notes": null }, { "name": "la", "label": "Left arm", "type": "number", "unit": "mm Hg", "required": false, "notes": null }, { "name": "leg", "label": "Leg", "type": "number", "unit": "mm Hg", "required": false, "notes": null } ], "input_notes": "Under 13 years, also enter sbp90, sbp95, dbp90 and dbp95 from the guideline table. The four-limb helper uses ra and leg (la optional).", "outputs": [ "AAP 2017 category and stage (normal, elevated, stage 1, stage 2)", "Screening flag (Table 6) and emergency threshold (Table 11)", "Right arm minus leg systolic gradient, flagged at 20 mm Hg or more" ], "sources": [ { "citation": "Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics 2017;140(3):e20171904. doi:10.1542/peds.2017-1904", "doi": "10.1542/peds.2017-1904" }, { "citation": "Erratum. Pediatrics 2017;140(6):e20173035.", "doi": "10.1542/peds.2017-3035" }, { "citation": "Erratum. Pediatrics 2018;142(3):e20181739.", "doi": "10.1542/peds.2018-1739" } ], "prefill_example": "https://heartcalc.doctorarichai.com/bp?ageY=10&sex=male&sbp=114&dbp=70&sbp90=112&sbp95=116&dbp90=74&dbp95=77&ra=114&la=112&leg=92" }, { "id": "qtc", "name": "QTc and LQTS Score", "url": "https://heartcalc.doctorarichai.com/qtc", "status": "verified", "group": "clinic", "group_label": "Clinic", "description": "QTc by Bazett, Fridericia, Framingham and Hodges from QT (ms) and heart rate or RR, with pediatric +2 SD context and the Schwartz 1993-2011 LQTS points score.", "keywords": "qt qtc bazett fridericia hodges framingham long qt schwartz ecg", "population": "Children and adults with a resting ECG. Phan 2015 +2 SD values apply to children 6 years or younger. The Schwartz score estimates the probability of long QT syndrome from clinical findings; it does not replace genetic testing or specialist review.", "method_url": "https://heartcalc.doctorarichai.com/qtc#method", "inputs": [ { "name": "ageY", "label": "Age", "type": "number", "unit": "years", "min": 0, "required": false, "notes": null }, { "name": "sex", "label": "Sex", "type": "select", "unit": null, "options": [ { "value": "male", "label": "Male" }, { "value": "female", "label": "Female" } ], "required": false, "notes": null }, { "name": "qt", "label": "QT interval", "type": "number", "unit": "ms", "required": true, "notes": "Example: 400." }, { "name": "rateMode", "label": "Rate entered as", "type": "radio", "unit": null, "options": [ { "value": "hr", "label": "Heart rate (bpm)" }, { "value": "rr", "label": "RR interval (ms)" } ], "required": true, "notes": "No default: pick one." }, { "name": "hr", "label": "Heart rate", "type": "number", "unit": "bpm", "required": false, "notes": "Used when rateMode is hr." }, { "name": "rr", "label": "Preceding RR interval", "type": "number", "unit": "ms", "required": false, "notes": "Used when rateMode is rr." }, { "name": "confounder", "label": "QT-affecting medication or disorder present", "type": "checkbox", "unit": null, "required": false, "notes": "e.g. QT-prolonging drugs, electrolyte disturbance, bundle branch block. 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Circulation 2011;124(20):2181-2184. doi:10.1161/CIRCULATIONAHA.111.062182", "doi": "10.1161/CIRCULATIONAHA.111.062182" }, { "citation": "Schwartz PJ, Moss AJ, Vincent GM, Crampton RS. Diagnostic criteria for the long QT syndrome: an update. Circulation 1993;88(2):782-784. doi:10.1161/01.cir.88.2.782", "doi": "10.1161/01.cir.88.2.782" }, { "citation": "Saarel EV, Granger S, Kaltman JR, et al. Electrocardiograms in healthy North American children in the digital age. Circ Arrhythm Electrophysiol 2018;11(7):e005808. doi:10.1161/CIRCEP.117.005808", "doi": "10.1161/CIRCEP.117.005808" }, { "citation": "Rautaharju PM, Surawicz B, Gettes LS, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram, part IV. 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ERJ Open Res 2019;5(2):00056-2018. doi:10.1183/23120541.00056-2018", "doi": "10.1183/23120541.00056-2018" } ], "prefill_example": "https://heartcalc.doctorarichai.com/cpet?meas=31.5&measU=mL%2Fkg%2Fmin&pred=42&predU=mL%2Fkg%2Fmin&kg=45&refName=illustrative%20value" } ], "references": [ { "id": "refs", "name": "Bedside References", "url": "https://heartcalc.doctorarichai.com/refs", "description": "High-yield bedside references for pediatric cardiology: guideline recommendations and checklists, condensed from the source with class and level of evidence, each page cited." }, { "id": "refs-echo", "name": "Echocardiogram Calculators and References", "url": "https://heartcalc.doctorarichai.com/refs/echo", "description": "Echo references for pediatric cardiology, organised like an echo report: ventricular function, chambers, valves, great arteries and coronaries, pressures and shunts. 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Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: Task Force 2: preparticipation screening for cardiovascular disease in competitive athletes. Circulation 2015;132(22):e267-e272. doi:10.1161/CIR.0000000000000238", "doi": "10.1161/CIR.0000000000000238" }, { "citation": "Kim JH, Baggish AL, Levine BD, et al. Clinical considerations for competitive sports participation for athletes with cardiovascular abnormalities: a scientific statement from the American Heart Association and American College of Cardiology. Circulation 2025;151(11):e716-e761. doi:10.1161/CIR.0000000000001297", "doi": "10.1161/CIR.0000000000001297" }, { "citation": "Maron BJ, Thompson PD, Ackerman MJ, et al. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update. Circulation 2007;115(12):1643-1655. doi:10.1161/CIRCULATIONAHA.107.181423", "doi": "10.1161/CIRCULATIONAHA.107.181423" }, { "citation": "Kim JH, Baggish AL, Coleman D, et al. Opposing legislative mandates for ECG screening in competitive athletes: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 2026;87(14):1845-1852. doi:10.1016/j.jacc.2025.10.015", "doi": "10.1016/j.jacc.2025.10.015" } ] }, { "id": "icd", "name": "ICD Indications (Pediatric)", "url": "https://heartcalc.doctorarichai.com/refs/icd", "description": "ICD indications in children and young people with heart disease (21 years and under): the 2021 PACES expert consensus by condition and class of recommendation, with the 2024 AHA/ACC rows for HCM.", "method_url": "https://heartcalc.doctorarichai.com/refs/icd#method", "sources": [ { "citation": "Shah MJ, Silka MJ, Silva JNA, et al. 2021 PACES expert consensus statement on the indications and management of cardiovascular implantable electronic devices in pediatric patients. Heart Rhythm 2021;18(11):1888-1924. doi:10.1016/j.hrthm.2021.07.038", "doi": "10.1016/j.hrthm.2021.07.038" }, { "citation": "Ommen SR, Ho CY, Asif IM, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophic cardiomyopathy. Circulation 2024;149(23):e1239-e1311. doi:10.1161/CIR.0000000000001250", "doi": "10.1161/CIR.0000000000001250" } ] }, { "id": "pacemaker", "name": "Pacemaker Indications (Pediatric)", "url": "https://heartcalc.doctorarichai.com/refs/pacemaker", "description": "Permanent pacemaker indications in children and young people (21 years and under): every 2021 PACES pacemaker recommendation (Section 2) by condition and class, with the 2023 HRS rows on pacing site and resynchronization in pediatric and congenital heart disease.", "method_url": "https://heartcalc.doctorarichai.com/refs/pacemaker#method", "sources": [ { "citation": "Shah MJ, Silka MJ, Silva JNA, et al. 2021 PACES expert consensus statement on the indications and management of cardiovascular implantable electronic devices in pediatric patients. Heart Rhythm 2021;18(11):1888-1924. doi:10.1016/j.hrthm.2021.07.038", "doi": "10.1016/j.hrthm.2021.07.038" }, { "citation": "Chung MK, Patton KK, Lau CP, et al. 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure. Heart Rhythm 2023;20(9):e17-e91. doi:10.1016/j.hrthm.2023.03.1538", "doi": "10.1016/j.hrthm.2023.03.1538" }, { "citation": "Groh WJ, Bhakta D, Tomaselli GF, et al. 2022 HRS expert consensus statement on evaluation and management of arrhythmic risk in neuromuscular disorders. Heart Rhythm 2022;19(10):e61-e120. doi:10.1016/j.hrthm.2022.04.022", "doi": "10.1016/j.hrthm.2022.04.022" } ] }, { "id": "cardiomyopathy", "name": "Cardiomyopathy in Children: Diagnosis and Management", "url": "https://heartcalc.doctorarichai.com/refs/cardiomyopathy", "description": "Cardiomyopathy in children, with adult values labelled: phenotypes as the 2023 ESC guideline defines them (HCM, DCM, NDLVC, ARVC, RCM; LVNC as each source treats it), diagnostic cut-offs, work-up and red flags, graded management, family screening and genetic testing, follow-up, and a finder for late gadolinium enhancement (LGE) patterns on cardiac MRI.", "method_url": "https://heartcalc.doctorarichai.com/refs/cardiomyopathy#method", "sources": [ { "citation": "Arbelo E, Protonotarios A, Gimeno JR, et al.; ESC Scientific Document Group. 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J 2023;44(37):3503-3626. doi:10.1093/eurheartj/ehad194", "doi": "10.1093/eurheartj/ehad194" }, { "citation": "Correction to: 2023 ESC Guidelines for the management of cardiomyopathies. Eur Heart J 2026;47(38):5557. doi:10.1093/eurheartj/ehag645", "doi": "10.1093/eurheartj/ehag645" }, { "citation": "Ommen SR, Ho CY, Asif IM, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophic cardiomyopathy. Circulation 2024;149(23):e1239-e1311. doi:10.1161/CIR.0000000000001250", "doi": "10.1161/CIR.0000000000001250" }, { "citation": "Correction to: 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophic cardiomyopathy. Circulation 2024;150(8):e198. doi:10.1161/CIR.0000000000001277", "doi": "10.1161/CIR.0000000000001277" }, { "citation": "Lipshultz SE, Law YM, Asante-Korang A, et al. Cardiomyopathy in children: classification and diagnosis: a scientific statement from the American Heart Association. Circulation 2019;140(1):e9-e68. doi:10.1161/CIR.0000000000000682", "doi": "10.1161/CIR.0000000000000682" }, { "citation": "Irving C, Azeka E, Adorisio R, et al. The International Society for Heart and Lung Transplantation guidelines for the management of pediatric heart failure (update from 2014). J Heart Lung Transplant 2025;44(10):e21-e71. doi:10.1016/j.healun.2025.06.003", "doi": "10.1016/j.healun.2025.06.003" }, { "citation": "Bogle C, Colan SD, Miyamoto SD, et al. Treatment strategies for cardiomyopathy in children: a scientific statement from the American Heart Association. Circulation 2023;148(2):174-195. doi:10.1161/CIR.0000000000001151", "doi": "10.1161/CIR.0000000000001151" }, { "citation": "Canter CE, Shaddy RE, Bernstein D, et al. Indications for heart transplantation in pediatric heart disease: a scientific statement from the American Heart Association. Circulation 2007;115(5):658-676. doi:10.1161/CIRCULATIONAHA.106.180449", "doi": "10.1161/CIRCULATIONAHA.106.180449" }, { "citation": "Towbin JA, McKenna WJ, Abrams DJ, et al. 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy. Heart Rhythm 2019;16(11):e301-e372. doi:10.1016/j.hrthm.2019.05.007", "doi": "10.1016/j.hrthm.2019.05.007" }, { "citation": "Marcus FI, McKenna WJ, Sherrill D, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria. Circulation 2010;121(13):1533-1541. doi:10.1161/CIRCULATIONAHA.108.840827", "doi": "10.1161/CIRCULATIONAHA.108.840827" }, { "citation": "Marcus FI, McKenna WJ, Sherrill D, et al. Diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia: proposed modification of the Task Force Criteria. Eur Heart J 2010;31(7):806-814. doi:10.1093/eurheartj/ehq025", "doi": "10.1093/eurheartj/ehq025" }, { "citation": "Corrado D, Anastasakis A, Basso C, et al. Proposed diagnostic criteria for arrhythmogenic cardiomyopathy: European Task Force consensus report. Int J Cardiol 2024;395:131447. doi:10.1016/j.ijcard.2023.131447", "doi": "10.1016/j.ijcard.2023.131447" }, { "citation": "Corrado D, Perazzolo Marra M, Zorzi A, et al. Diagnosis of arrhythmogenic cardiomyopathy: the Padua criteria. Int J Cardiol 2020;319:106-114. doi:10.1016/j.ijcard.2020.06.005", "doi": "10.1016/j.ijcard.2020.06.005" }, { "citation": "Cummings KW, Bhalla S, Javidan-Nejad C, Bierhals AJ, Gutierrez FR, Woodard PK. A pattern-based approach to assessment of delayed enhancement in nonischemic cardiomyopathy at MR imaging. RadioGraphics 2009;29(1):89-103. doi:10.1148/rg.291085052", "doi": "10.1148/rg.291085052" }, { "citation": "Hershberger RE, Givertz MM, Ho CY, et al. Genetic evaluation of cardiomyopathy: a Heart Failure Society of America practice guideline. J Card Fail 2018;24(5):281-302. doi:10.1016/j.cardfail.2018.03.004", "doi": "10.1016/j.cardfail.2018.03.004" }, { "citation": "Hershberger RE, Givertz MM, Ho CY, et al. Genetic evaluation of cardiomyopathy: a clinical practice resource of the American College of Medical Genetics and Genomics (ACMG). Genet Med 2018;20(9):899-909. doi:10.1038/s41436-018-0039-z", "doi": "10.1038/s41436-018-0039-z" }, { "citation": "Wilde AAM, Semsarian C, Márquez MF, et al. European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus statement on the state of genetic testing for cardiac diseases. Europace 2022;24(8):1307-1367. doi:10.1093/europace/euac030", "doi": "10.1093/europace/euac030" }, { "citation": "Mahrholdt H, Wagner A, Judd RM, Sechtem U, Kim RJ. Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies. Eur Heart J 2005;26(15):1461-1474. doi:10.1093/eurheartj/ehi258", "doi": "10.1093/eurheartj/ehi258" }, { "citation": "Smedsrud MK, Chivulescu M, Forså MI, et al. Highly malignant disease in childhood-onset arrhythmogenic right ventricular cardiomyopathy. Eur Heart J 2022;43(45):4694-4703. doi:10.1093/eurheartj/ehac485", "doi": "10.1093/eurheartj/ehac485" } ] }, { "id": "antithrombotics", "name": "Antithrombotic Therapy in Pediatric Heart Disease", "url": "https://heartcalc.doctorarichai.com/refs/antithrombotics", "description": "Antithrombotic therapy in pediatric heart disease by lesion and procedure: systemic-to-PA shunt and Norwood, RV-PA conduit, ductal or RVOT stent, Glenn, Fontan, mechanical and bioprosthetic valves, endovascular stents and devices, and catheter-related thrombosis. Agent, start, target, duration and monitoring, with every graded row by source as printed: AATS 2026 (neonates and infants), AHA 2013, CHEST 2012, ASH 2018, and ACHD 2025 (adult, labelled). UFH and LMWH anti-Xa ranges, INR targets and aspirin dose ranges as printed.", "method_url": "https://heartcalc.doctorarichai.com/refs/antithrombotics#method", "sources": [ { "citation": "Nathan M, Kiskaddon AL, Emani S, et al. 2026 American Association for Thoracic Surgery (AATS) expert consensus statement: antithrombotic management of neonates/infants undergoing cardiac interventions. J Thorac Cardiovasc Surg 2026;172(3):618-662.e7. doi:10.1016/j.jtcvs.2026.03.617", "doi": "10.1016/j.jtcvs.2026.03.617" }, { "citation": "Giglia TM, Massicotte MP, Tweddell JS, et al. Prevention and treatment of thrombosis in pediatric and congenital heart disease: a scientific statement from the American Heart Association. Circulation 2013;128(24):2622-2703. doi:10.1161/01.cir.0000436140.77832.7a", "doi": "10.1161/01.cir.0000436140.77832.7a" }, { "citation": "Monagle P, Chan AKC, Goldenberg NA, et al. Antithrombotic therapy in neonates and children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012;141(2 Suppl):e737S-e801S. doi:10.1378/chest.11-2308", "doi": "10.1378/chest.11-2308" }, { "citation": "Monagle P, Cuello CA, Augustine C, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv 2018;2(22):3292-3316. doi:10.1182/bloodadvances.2018024786", "doi": "10.1182/bloodadvances.2018024786" }, { "citation": "Rychik J, Atz AM, Celermajer DS, et al. Evaluation and management of the child and adult with Fontan circulation: a scientific statement from the American Heart Association. Circulation 2019;140(6):e234-e284. doi:10.1161/CIR.0000000000000696", "doi": "10.1161/CIR.0000000000000696" }, { "citation": "Gurvitz M, Krieger EV, Fuller S, et al. 2025 ACC/AHA/HRS/ISACHD/SCAI guideline for the management of adults with congenital heart disease. Circulation 2026;153(8):e115-e251 (also J Am Coll Cardiol 2026;87(7):822-976). doi:10.1161/CIR.0000000000001402", "doi": "10.1161/CIR.0000000000001402" }, { "citation": "McCrindle BW, Michelson AD, Van Bergen AH, et al. Thromboprophylaxis for children post-Fontan procedure: insights from the UNIVERSE study. J Am Heart Assoc 2021;10(22):e021765. doi:10.1161/JAHA.120.021765", "doi": "10.1161/JAHA.120.021765" }, { "citation": "Payne RM, Burns KM, Glatz AC, et al. Apixaban for prevention of thromboembolism in pediatric heart disease. J Am Coll Cardiol 2023;82(24):2296-2309. doi:10.1016/j.jacc.2023.10.010", "doi": "10.1016/j.jacc.2023.10.010" }, { "citation": "Portman MA, Jacobs JP, Newburger JW, et al. Edoxaban for thromboembolism prevention in pediatric patients with cardiac disease. J Am Coll Cardiol 2022;80(24):2301-2310. doi:10.1016/j.jacc.2022.09.031", "doi": "10.1016/j.jacc.2022.09.031" }, { "citation": "Derridj N, Linglart L, Lasne D, et al. Thromboprophylaxis in congenital and acquired heart disease across the lifespan. A French consensus position statement: Part 1, from infancy to adolescence. Arch Cardiovasc Dis 2026. doi:10.1016/j.acvd.2026.07.005", "doi": "10.1016/j.acvd.2026.07.005" } ] }, { "id": "myocarditis", "name": "Myocarditis: Diagnosis and Imaging", "url": "https://heartcalc.doctorarichai.com/refs/myocarditis", "description": "Myocarditis in children, neonates and adults: when to suspect it, diagnostic certainty (AHA 2021 strata, ESC 2025 definite and possible), graded tests (JCS 2023 pediatric and neonatal, ESC 2025), labs, ECG, echo, the updated Lake Louise Criteria for CMR, other imaging, biopsy and red flags for fulminant myocarditis.", "method_url": "https://heartcalc.doctorarichai.com/refs/myocarditis#method", "sources": [ { "citation": "Law YM, Lal AK, Chen S, et al.; AHA Pediatric Heart Failure and Transplantation Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young and Stroke Council. Diagnosis and management of myocarditis in children: a scientific statement from the American Heart Association. Circulation 2021;144(6):e123-e135. doi:10.1161/CIR.0000000000001001", "doi": "10.1161/CIR.0000000000001001" }, { "citation": "Correction to: Diagnosis and management of myocarditis in children: a scientific statement from the American Heart Association. Circulation 2021;144(6):e149. doi:10.1161/CIR.0000000000001011", "doi": "10.1161/CIR.0000000000001011" }, { "citation": "Nagai T, Inomata T, Kohno T, et al. JCS 2023 guideline on the diagnosis and treatment of myocarditis. Circ J 2023;87(5):674-754. doi:10.1253/circj.CJ-22-0696", "doi": "10.1253/circj.CJ-22-0696" }, { "citation": "Schulz-Menger J, Collini V, Gröschel J, Adler Y, et al. 2025 ESC Guidelines for the management of myocarditis and pericarditis. Eur Heart J 2025;46(40):3952-4041. doi:10.1093/eurheartj/ehaf192", "doi": "10.1093/eurheartj/ehaf192" }, { "citation": "Ferreira VM, Schulz-Menger J, Holmvang G, et al. Cardiovascular magnetic resonance in nonischemic myocardial inflammation: expert recommendations. J Am Coll Cardiol 2018;72(24):3158-3176. doi:10.1016/j.jacc.2018.09.072", "doi": "10.1016/j.jacc.2018.09.072" }, { "citation": "Drazner MH, Bozkurt B, Cooper LT, et al. 2024 ACC Expert Consensus Decision Pathway on strategies and criteria for the diagnosis and management of myocarditis. J Am Coll Cardiol 2025;85(4):391-431. doi:10.1016/j.jacc.2024.10.080", "doi": "10.1016/j.jacc.2024.10.080" }, { "citation": "Kociol RD, Cooper LT, Fang JC, et al. Recognition and initial management of fulminant myocarditis: a scientific statement from the American Heart Association. Circulation 2020;141(6):e69-e92. doi:10.1161/CIR.0000000000000745", "doi": "10.1161/CIR.0000000000000745" }, { "citation": "Messroghli DR, Moon JC, Ferreira VM, et al. Clinical recommendations for cardiovascular magnetic resonance mapping of T1, T2, T2* and extracellular volume: a consensus statement by the Society for Cardiovascular Magnetic Resonance (SCMR) endorsed by the European Association for Cardiovascular Imaging (EACVI). J Cardiovasc Magn Reson 2017;19:75. doi:10.1186/s12968-017-0389-8", "doi": "10.1186/s12968-017-0389-8" }, { "citation": "Cornicelli MD, Rigsby CK, Rychlik K, et al. Diagnostic performance of cardiovascular magnetic resonance native T1 and T2 mapping in pediatric patients with acute myocarditis. J Cardiovasc Magn Reson 2019;21:40. doi:10.1186/s12968-019-0550-7", "doi": "10.1186/s12968-019-0550-7" }, { "citation": "Banka P, Robinson JD, Uppu SC, et al. Cardiovascular magnetic resonance techniques and findings in children with myocarditis: a multicenter retrospective study. J Cardiovasc Magn Reson 2015;17:96. doi:10.1186/s12968-015-0201-6", "doi": "10.1186/s12968-015-0201-6" }, { "citation": "Ammirati E, Cipriani M, Moro C, et al. Clinical presentation and outcome in a contemporary cohort of patients with acute myocarditis: Multicenter Lombardy Registry. Circulation 2018;138(11):1088-1099. doi:10.1161/CIRCULATIONAHA.118.035319", "doi": "10.1161/CIRCULATIONAHA.118.035319" }, { "citation": "Younis A, Matetzky S, Mulla W, et al. Epidemiology characteristics and outcome of patients with clinically diagnosed acute myocarditis. Am J Med 2020;133(4):492-499. doi:10.1016/j.amjmed.2019.10.015", "doi": "10.1016/j.amjmed.2019.10.015" } ] }, { "id": "aortopathy", "name": "Aortopathy (All Ages)", "url": "https://heartcalc.doctorarichai.com/refs/aortopathy", "description": "Aortopathy from fetus to adult: how aortic size is indexed by age, rapid-growth definitions, and surgical thresholds for Marfan, Loeys-Dietz by gene, vascular EDS, other heritable thoracic aortic disease genes, bicuspid aortic valve, Turner and repaired congenital heart disease, from the AHA 2024 pediatric statement and the ACC/AHA 2022 and ESC 2024 guidelines (adult, labelled), with classes of recommendation.", "method_url": "https://heartcalc.doctorarichai.com/refs/aortopathy#method", "sources": [ { "citation": "Morris SA, Flyer JN, Yetman AT, et al.; AHA Council on Lifelong Congenital Heart Disease and Heart Health in the Young, et al. Cardiovascular management of aortopathy in children: a scientific statement from the American Heart Association. Circulation 2024;150(11):e228-e254. doi:10.1161/CIR.0000000000001265", "doi": "10.1161/CIR.0000000000001265" }, { "citation": "Muiño-Mosquera L, Cervi E, De Groote K, et al. Management of aortic disease in children with FBN1-related Marfan syndrome. Eur Heart J 2024;45(39):4156-4169. doi:10.1093/eurheartj/ehae526", "doi": "10.1093/eurheartj/ehae526" }, { "citation": "Isselbacher EM, Preventza O, Hamilton Black J 3rd, et al. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease. Circulation 2022;146(24):e334-e482 (co-published J Am Coll Cardiol 2022;80(24):e223-e393). doi:10.1161/CIR.0000000000001106", "doi": "10.1161/CIR.0000000000001106" }, { "citation": "Gurvitz M, et al. (Writing Committee). 2025 ACC/AHA/HRS/ISACHD/SCAI guideline for the management of adults with congenital heart disease. Circulation 2026;153(8):e115-e251 (also J Am Coll Cardiol, 10.1016/j.jacc.2025.09.006). doi:10.1161/CIR.0000000000001402", "doi": "10.1161/CIR.0000000000001402" }, { "citation": "Kim JH, Baggish AL, Levine BD, et al. Clinical considerations for competitive sports participation for athletes with cardiovascular abnormalities: a scientific statement from the AHA and ACC. Circulation 2025;151(11):e716-e761. doi:10.1161/CIR.0000000000001297", "doi": "10.1161/CIR.0000000000001297" }, { "citation": "Mazzolai L, Teixido-Tura G, Lanzi S, et al. 2024 ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J 2024;45(36):3538-3700. doi:10.1093/eurheartj/ehae179", "doi": "10.1093/eurheartj/ehae179" }, { "citation": "MacCarrick G, Black JH 3rd, Bowdin S, et al. Loeys-Dietz syndrome: a primer for diagnosis and management. Genet Med 2014;16(8):576-587. doi:10.1038/gim.2014.11", "doi": "10.1038/gim.2014.11" }, { "citation": "Lacro RV, Dietz HC, Sleeper LA, et al.; Pediatric Heart Network Investigators. Atenolol versus losartan in children and young adults with Marfan's syndrome. N Engl J Med 2014;371(22):2061-2071. doi:10.1056/NEJMoa1404731", "doi": "10.1056/NEJMoa1404731" }, { "citation": "Ong KT, Perdu J, De Backer J, et al. Effect of celiprolol on prevention of cardiovascular events in vascular Ehlers-Danlos syndrome: a prospective randomised, open, blinded-endpoints trial. Lancet 2010;376(9751):1476-1484 (erratum Lancet 2016;388:564, dosage). doi:10.1016/S0140-6736(10)60960-9", "doi": "10.1016/S0140-6736(10)60960-9" }, { "citation": "Byers PH, Belmont J, Black J, et al. Diagnosis, natural history, and management in vascular Ehlers-Danlos syndrome. Am J Med Genet C Semin Med Genet 2017;175(1):40-47. doi:10.1002/ajmg.c.31553", "doi": "10.1002/ajmg.c.31553" }, { "citation": "Loeys BL, Dietz HC, Braverman AC, et al. The revised Ghent nosology for the Marfan syndrome. J Med Genet 2010;47(7):476-485. doi:10.1136/jmg.2009.072785", "doi": "10.1136/jmg.2009.072785" } ] }, { "id": "tof", "name": "Repaired Tetralogy of Fallot", "url": "https://heartcalc.doctorarichai.com/refs/tof", "description": "Repaired tetralogy of Fallot: how often to repeat echo, CMR, exercise testing, ECG and Holter by age, the CMR and echo thresholds that matter (PR fraction, RVESVi, RVEDVi, RVEF, LVEF, RV pressure, QRS, TR, branch PAs), and pulmonary valve replacement indications: the AHA 2024 framework (no class), STS 2026 and AHA 2011 rows, and the adult ACHD 2025 and ESC 2020 guidelines with class and level (adult, labelled). Imaging schedules from AHA 2024, ASE 2014 and ACHD 2025.", "method_url": "https://heartcalc.doctorarichai.com/refs/tof#method", "sources": [ { "citation": "Geva T, Wald RM, Bucholz E, et al.; AHA Council on Lifelong Congenital Heart Disease and Heart Health in the Young, et al. Long-term management of right ventricular outflow tract dysfunction in repaired tetralogy of Fallot: a scientific statement from the American Heart Association. Circulation 2024;150(25):e689-e707. doi:10.1161/CIR.0000000000001291", "doi": "10.1161/CIR.0000000000001291" }, { "citation": "Valente AM, Cook S, Festa P, et al. Multimodality imaging guidelines for patients with repaired tetralogy of Fallot: a report from the American Society of Echocardiography. J Am Soc Echocardiogr 2014;27(2):111-141. doi:10.1016/j.echo.2013.11.009", "doi": "10.1016/j.echo.2013.11.009" }, { "citation": "Nelson JS, Lu JC, Ashfaq A, et al. The Society of Thoracic Surgeons/World Society for Pediatric and Congenital Heart Surgery/European Congenital Heart Surgeons Association 2026 clinical practice guidelines on indications and timing of pulmonary valve replacement in repaired tetralogy of Fallot. Ann Thorac Surg 2026. doi:10.1016/j.athoracsur.2026.04.011", "doi": "10.1016/j.athoracsur.2026.04.011" }, { "citation": "Khanna AD, Stephens EH, Jacobs JP, et al. The Society of Thoracic Surgeons (STS)/World Society for Pediatric and Congenital Heart Surgery (WSPCHS)/European Congenital Heart Surgeons Association (ECHSA) expert opinion on the role of exercise testing in determining optimal timing of pulmonary valve replacement in tetralogy of Fallot. Ann Thorac Surg 2026. doi:10.1016/j.athoracsur.2026.05.010", "doi": "10.1016/j.athoracsur.2026.05.010" }, { "citation": "Feltes TF, Bacha E, Beekman RH 3rd, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 2011;123(22):2607-2652. doi:10.1161/CIR.0b013e31821b1f10", "doi": "10.1161/CIR.0b013e31821b1f10" }, { "citation": "Gurvitz M, Krieger EV, Fuller S, et al. (Writing Committee). 2025 ACC/AHA/HRS/ISACHD/SCAI guideline for the management of adults with congenital heart disease. Circulation 2026;153(8):e115-e251 (also J Am Coll Cardiol, 10.1016/j.jacc.2025.09.006). doi:10.1161/CIR.0000000000001402", "doi": "10.1161/CIR.0000000000001402" }, { "citation": "Baumgartner H, De Backer J, Babu-Narayan SV, et al. 2020 ESC Guidelines for the management of adult congenital heart disease. Eur Heart J 2021;42(6):563-645. doi:10.1093/eurheartj/ehaa554", "doi": "10.1093/eurheartj/ehaa554" }, { "citation": "Stephens EH, Zampi JD, Sarris GE, et al. The Society of Thoracic Surgeons / World Society for Pediatric and Congenital Heart Surgery / European Congenital Heart Surgeons Association 2026 expert consensus document on timing, indications, and options for pulmonary valve replacement in children with repaired tetralogy of Fallot. Ann Thorac Surg 2026. doi:10.1016/j.athoracsur.2026.07.010", "doi": "10.1016/j.athoracsur.2026.07.010" }, { "citation": "Bokma JP, de Wilde KC, Vliegen HW, et al. Value of cardiovascular magnetic resonance imaging in noninvasive risk stratification in tetralogy of Fallot. JAMA Cardiol 2017;2(6):678-683. doi:10.1001/jamacardio.2016.5818", "doi": "10.1001/jamacardio.2016.5818" }, { "citation": "Atallah J, Gonzalez Corcia MC, Walsh EP; Pediatric and Congenital Electrophysiology Society. Ventricular arrhythmia and life-threatening events in patients with repaired tetralogy of Fallot. Am J Cardiol 2020;132:126-132. doi:10.1016/j.amjcard.2020.07.012", "doi": "10.1016/j.amjcard.2020.07.012" } ] }, { "id": "aaoca", "name": "Anomalous Aortic Origin of a Coronary Artery (AAOCA)", "url": "https://heartcalc.doctorarichai.com/refs/aaoca", "description": "Anomalous aortic origin of a coronary artery (AAOCA), right (AAORCA) and left (AAOLCA): high-risk anatomy as each source defines it, how to image (echo views, CT, CMR), ischemia testing, surgery indications with class and level (AATS 2017; adult ACHD 2025 and ESC 2020, labelled), sports participation and return to play (AHA/ACC 2025, AATS 2017, ESC 2020), and follow-up after repair.", "method_url": "https://heartcalc.doctorarichai.com/refs/aaoca#method", "sources": [ { "citation": "Brothers JA, Frommelt MA, Jaquiss RDB, Myerburg RJ, Fraser CD Jr, Tweddell JS. Expert consensus guidelines: anomalous aortic origin of a coronary artery. J Thorac Cardiovasc Surg 2017;153(6):1440-1457. doi:10.1016/j.jtcvs.2016.06.066", "doi": "10.1016/j.jtcvs.2016.06.066" }, { "citation": "Kim JH, Baggish AL, Levine BD, et al. Clinical considerations for competitive sports participation for athletes with cardiovascular abnormalities: a scientific statement from the American Heart Association and American College of Cardiology. J Am Coll Cardiol 2025;85(10):1059-1108; Circulation 2025;151(11):e716-e761. doi:10.1016/j.jacc.2024.12.025", "doi": "10.1016/j.jacc.2024.12.025" }, { "citation": "Olivieri LJ, Lee S, Chen MH, et al. Multimodality approach to coronary ischemic testing in pediatric patients: a scientific statement from the American Heart Association. J Am Heart Assoc 2026;15(8):e047790. doi:10.1161/JAHA.125.047790", "doi": "10.1161/JAHA.125.047790" }, { "citation": "Frommelt P, Lopez L, Dimas VV, et al. Recommendations for multimodality assessment of congenital coronary anomalies: a guide from the American Society of Echocardiography. J Am Soc Echocardiogr 2020;33(3):259-294. doi:10.1016/j.echo.2019.10.011", "doi": "10.1016/j.echo.2019.10.011" }, { "citation": "Gurvitz M, Krieger EV, Fuller S, et al. 2025 ACC/AHA/HRS/ISACHD/SCAI guideline for the management of adults with congenital heart disease. Circulation 2026;153(8):e115-e251 (also J Am Coll Cardiol 2026;87(7):822-976). doi:10.1161/CIR.0000000000001402", "doi": "10.1161/CIR.0000000000001402" }, { "citation": "Baumgartner H, De Backer J, Babu-Narayan SV, et al. 2020 ESC Guidelines for the management of adult congenital heart disease. Eur Heart J 2021;42(6):563-645. doi:10.1093/eurheartj/ehaa554", "doi": "10.1093/eurheartj/ehaa554" }, { "citation": "Pelliccia A, Sharma S, Gati S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J 2021;42(1):17-96. doi:10.1093/eurheartj/ehaa605", "doi": "10.1093/eurheartj/ehaa605" }, { "citation": "Jegatheeswaran A, Devlin PJ, McCrindle BW, et al. Features associated with myocardial ischemia in anomalous aortic origin of a coronary artery: a Congenital Heart Surgeons' Society study. J Thorac Cardiovasc Surg 2019;158(3):822-834.e3. doi:10.1016/j.jtcvs.2019.02.122", "doi": "10.1016/j.jtcvs.2019.02.122" }, { "citation": "Molossi S, Agrawal H, Mery CM, et al. Outcomes in anomalous aortic origin of a coronary artery following a prospective standardized approach. Circ Cardiovasc Interv 2020;13(2):e008445. doi:10.1161/CIRCINTERVENTIONS.119.008445", "doi": "10.1161/CIRCINTERVENTIONS.119.008445" }, { "citation": "Doan TT, Wilkes JK, Reaves O'Neal DL, et al. Clinical presentation and medium-term outcomes of children with anomalous aortic origin of the left coronary artery: high-risk features beyond interarterial course. Circ Cardiovasc Interv 2023;16(5):e012635. doi:10.1161/CIRCINTERVENTIONS.122.012635", "doi": "10.1161/CIRCINTERVENTIONS.122.012635" }, { "citation": "Doan TT, Sachdeva S, Bonilla-Ramirez C, et al. Ischemia in anomalous aortic origin of a right coronary artery: large pediatric cohort medium-term outcomes. Circ Cardiovasc Interv 2023;16(4):e012631. doi:10.1161/CIRCINTERVENTIONS.122.012631", "doi": "10.1161/CIRCINTERVENTIONS.122.012631" } ] }, { "id": "genetics-chd", "name": "Genetic Testing in Congenital Heart Disease", "url": "https://heartcalc.doctorarichai.com/refs/genetics-chd", "description": "Genetic testing in congenital heart disease: which test to send for each lesion (CMA, 22q11.2 deletion, karyotype, gene panels, exome or genome sequencing), how often each lesion carries a 22q11.2 deletion or aneuploidy, when to refer to genetics, recurrence risk by affected relative (AHA 2018 Table 10), and the cardiac screening sources state for trisomy 21, Noonan, Holt-Oram and other syndromes. AHA 2018, NSGC 2021, ACMG 2021, AHA 2021, AHA 2014 fetal, AAP 2022, AHA 2024; adult rows from ACHD 2025 labelled.", "method_url": "https://heartcalc.doctorarichai.com/refs/genetics-chd#method", "sources": [ { "citation": "Pierpont ME, Brueckner M, Chung WK, et al.; American Heart Association Council on Cardiovascular Disease in the Young, et al. Genetic basis for congenital heart disease: revisited: a scientific statement from the American Heart Association. Circulation 2018;138(21):e653-e711. doi:10.1161/CIR.0000000000000606", "doi": "10.1161/CIR.0000000000000606" }, { "citation": "Ison HE, Griffin EL, Parrott A, et al. Genetic counseling for congenital heart disease: practice resource of the National Society of Genetic Counselors. J Genet Couns 2022;31(1):9-33 (online 2021). doi:10.1002/jgc4.1498", "doi": "10.1002/jgc4.1498" }, { "citation": "Manickam K, McClain MR, Demmer LA, et al. Exome and genome sequencing for pediatric patients with congenital anomalies or intellectual disability: an evidence-based clinical guideline of the American College of Medical Genetics and Genomics (ACMG). Genet Med 2021;23(11):2029-2037. doi:10.1038/s41436-021-01242-6", "doi": "10.1038/s41436-021-01242-6" }, { "citation": "Landstrom AP, Kim JJ, Gelb BD, et al.; American Heart Association Council on Genomic and Precision Medicine, et al. Genetic testing for heritable cardiovascular diseases in pediatric patients: a scientific statement from the American Heart Association. Circ Genom Precis Med 2021;14(5):e000086. doi:10.1161/HCG.0000000000000086", "doi": "10.1161/HCG.0000000000000086" }, { "citation": "Donofrio MT, Moon-Grady AJ, Hornberger LK, et al. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation 2014;129(21):2183-2242. doi:10.1161/01.cir.0000437597.44550.5d", "doi": "10.1161/01.cir.0000437597.44550.5d" }, { "citation": "Bull MJ, Trotter T, Santoro SL, et al.; Council on Genetics. Health supervision for children and adolescents with Down syndrome. Pediatrics 2022;149(5):e2022057010. doi:10.1542/peds.2022-057010", "doi": "10.1542/peds.2022-057010" }, { "citation": "Peterson JK, Clarke S, Gelb BD, et al. Trisomy 21 and congenital heart disease: impact on health and functional outcomes from birth through adolescence: a scientific statement from the American Heart Association. J Am Heart Assoc 2024;13(19):e036214. doi:10.1161/JAHA.124.036214", "doi": "10.1161/JAHA.124.036214" }, { "citation": "Durbin MD, Fairman K, Helvaty LR, et al. Genetic testing guidelines impact care in newborns with congenital heart defects. J Pediatr 2023;260:113495. doi:10.1016/j.jpeds.2023.113495", "doi": "10.1016/j.jpeds.2023.113495" }, { "citation": "Gurvitz M, Krieger EV, Fuller S, et al. (Writing Committee). 2025 ACC/AHA/HRS/ISACHD/SCAI guideline for the management of adults with congenital heart disease. Circulation 2026;153(8):e115-e251. doi:10.1161/CIR.0000000000001402", "doi": "10.1161/CIR.0000000000001402" }, { "citation": "St Louis JD, Bhat A, Carey JC, et al. The American Association for Thoracic Surgery (AATS) 2023 expert consensus document: recommendation for the care of children with trisomy 13 or trisomy 18 and a congenital heart defect. J Thorac Cardiovasc Surg 2024;167(5):1519-1532. doi:10.1016/j.jtcvs.2023.11.054", "doi": "10.1016/j.jtcvs.2023.11.054" } ] }, { "id": "echo-systolic", "name": "Echo: LV and RV Systolic Function", "url": "https://heartcalc.doctorarichai.com/refs/echo-systolic", "description": "Echo assessment of LV and RV systolic function in neonates and children: how ASE recommends measuring EF, fractional shortening, GLS, TAPSE, FAC, s′, RV strain and RIMP, with pediatric and neonatal reference values and adult ASE cut-offs.", "method_url": "https://heartcalc.doctorarichai.com/refs/echo-systolic#method", "sources": [ { "citation": "Lopez L, Saurers DL, Barker PCA, et al. Guidelines for performing a comprehensive pediatric transthoracic echocardiogram: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 2024;37:119-170. doi:10.1016/j.echo.2023.11.015", "doi": "10.1016/j.echo.2023.11.015" }, { "citation": "McNamara PJ, Jain A, El-Khuffash A, et al. Guidelines and recommendations for targeted neonatal echocardiography and cardiac point-of-care ultrasound in the NICU: an update from the ASE. J Am Soc Echocardiogr 2024;37:171-215. doi:10.1016/j.echo.2023.11.016", "doi": "10.1016/j.echo.2023.11.016" }, { "citation": "Lopez L, Colan SD, Frommelt PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram. J Am Soc Echocardiogr 2010;23:465-495. doi:10.1016/j.echo.2010.03.019", "doi": "10.1016/j.echo.2010.03.019" }, { "citation": "Mertens L, Seri I, Marek J, et al. Targeted neonatal echocardiography in the neonatal intensive care unit. J Am Soc Echocardiogr 2011;24:1057-1078. doi:10.1016/j.echo.2011.07.014", "doi": "10.1016/j.echo.2011.07.014" }, { "citation": "Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults. J Am Soc Echocardiogr 2015;28:1-39. doi:10.1016/j.echo.2014.10.003", "doi": "10.1016/j.echo.2014.10.003" }, { "citation": "Mukherjee M, Rudski LG, Addetia K, et al. Guidelines for the echocardiographic assessment of the right heart in adults and special considerations in pulmonary hypertension. J Am Soc Echocardiogr 2025;38:141-186. doi:10.1016/j.echo.2025.01.006", "doi": "10.1016/j.echo.2025.01.006" }, { "citation": "Thomas JD, Edvardsen T, Abraham T, et al. Clinical applications of strain echocardiography: a clinical consensus statement from the ASE developed with the EACVI. J Am Soc Echocardiogr 2025;38:985-1020. doi:10.1016/j.echo.2025.07.007", "doi": "10.1016/j.echo.2025.07.007" }, { "citation": "Frommelt PC, Minich LL, Trachtenberg FL, et al. Challenges with left ventricular functional parameters: the Pediatric Heart Network normal echocardiogram database. J Am Soc Echocardiogr 2019;32:1331-1338. doi:10.1016/j.echo.2019.05.025", "doi": "10.1016/j.echo.2019.05.025" }, { "citation": "Levy PT, Machefsky A, Sanchez AA, et al. Reference ranges of left ventricular strain measures by 2D speckle-tracking echocardiography in children: a systematic review and meta-analysis. J Am Soc Echocardiogr 2016;29:209-225. doi:10.1016/j.echo.2015.11.016", "doi": "10.1016/j.echo.2015.11.016" }, { "citation": "Levy PT, Sanchez Mejia AA, Machefsky A, et al. Normal ranges of right ventricular systolic and diastolic strain measures in children: a systematic review and meta-analysis. J Am Soc Echocardiogr 2014;27:549-560. doi:10.1016/j.echo.2014.01.015", "doi": "10.1016/j.echo.2014.01.015" }, { "citation": "Levy PT, Dioneda B, Holland MR, et al. Right ventricular function in preterm and term neonates: reference values for right ventricle areas and fractional area of change. J Am Soc Echocardiogr 2015;28:559-569. doi:10.1016/j.echo.2015.01.024", "doi": "10.1016/j.echo.2015.01.024" }, { "citation": "Levy PT, El-Khuffash A, Patel MD, et al. Maturational patterns of systolic ventricular deformation mechanics by 2D speckle-tracking echocardiography in preterm infants over the first year of age. J Am Soc Echocardiogr 2017;30:685-698. doi:10.1016/j.echo.2017.03.003", "doi": "10.1016/j.echo.2017.03.003" }, { "citation": "Koestenberger M, Ravekes W, Everett AD, et al. Right ventricular function in infants, children and adolescents: reference values of TAPSE in 640 healthy patients and calculation of z score values. J Am Soc Echocardiogr 2009;22:715-719. doi:10.1016/j.echo.2009.03.026", "doi": "10.1016/j.echo.2009.03.026" }, { "citation": "Koestenberger M, Nagel B, Ravekes W, et al. Systolic right ventricular function in preterm and term neonates: reference values of TAPSE in 258 patients and calculation of z-score values. Neonatology 2011;100:85-92. doi:10.1159/000322006", "doi": "10.1159/000322006" }, { "citation": "Koestenberger M, Nagel B, Ravekes W, et al. Reference values of tricuspid annular peak systolic velocity in healthy pediatric patients, calculation of z score, and comparison to TAPSE. Am J Cardiol 2012;109:116-121. doi:10.1016/j.amjcard.2011.08.013", "doi": "10.1016/j.amjcard.2011.08.013" }, { "citation": "Jain A, Mohamed A, El-Khuffash A, et al. A comprehensive echocardiographic protocol for assessing neonatal right ventricular dimensions and function in the transitional period. J Am Soc Echocardiogr 2014;27:1293-1304. doi:10.1016/j.echo.2014.08.018", "doi": "10.1016/j.echo.2014.08.018" }, { "citation": "Dallaire F, Slorach C, Bradley T, et al. Pediatric reference values and z score equations for left ventricular systolic strain measured by two-dimensional speckle-tracking echocardiography. J Am Soc Echocardiogr 2016;29:786-793. doi:10.1016/j.echo.2016.03.018", "doi": "10.1016/j.echo.2016.03.018" }, { "citation": "Romanowicz J, Ferraro AM, Harrington JK, et al. Pediatric normal values and z score equations for left and right ventricular strain by two-dimensional speckle-tracking echocardiography derived from a large cohort of healthy children. J Am Soc Echocardiogr 2023;36:310-323. doi:10.1016/j.echo.2022.11.006", "doi": "10.1016/j.echo.2022.11.006" }, { "citation": "Dallaire F, Slorach C, Hui W, et al. Reference values for pulse wave Doppler and tissue Doppler imaging in pediatric echocardiography. Circ Cardiovasc Imaging 2015;8:e002167. doi:10.1161/CIRCIMAGING.114.002167", "doi": "10.1161/CIRCIMAGING.114.002167" }, { "citation": "Roberson DA, Cui W, Chen Z, et al. Annular and septal Doppler tissue imaging in children: normal z-score tables and effects of age, heart rate, and body surface area. J Am Soc Echocardiogr 2007;20:1276-1284. doi:10.1016/j.echo.2007.02.023", "doi": "10.1016/j.echo.2007.02.023" }, { "citation": "Roberson DA, Cui W. Right ventricular Tei index in children: effect of method, age, body surface area, and heart rate. J Am Soc Echocardiogr 2007;20:764-770. doi:10.1016/j.echo.2006.11.002", "doi": "10.1016/j.echo.2006.11.002" }, { "citation": "Cui W, Roberson DA. Left ventricular Tei index in children: comparison of tissue Doppler imaging, pulsed wave Doppler, and M-mode echocardiography normal values. J Am Soc Echocardiogr 2006;19:1438-1445. doi:10.1016/j.echo.2006.06.006", "doi": "10.1016/j.echo.2006.06.006" } ] }, { "id": "echo-diastolic", "name": "Echo: Diastolic Function", "url": "https://heartcalc.doctorarichai.com/refs/echo-diastolic", "description": "Echo assessment of diastolic function in neonates and children: what the ASE pediatric and neonatal guidelines recommend, preterm and term reference values, pediatric left atrial volume indexing, filling-pressure studies, and the adult ASE 2025 algorithm for comparison.", "method_url": "https://heartcalc.doctorarichai.com/refs/echo-diastolic#method", "sources": [ { "citation": "Lopez L, Saurers DL, Barker PCA, et al. Guidelines for performing a comprehensive pediatric transthoracic echocardiogram: recommendations from the ASE. J Am Soc Echocardiogr 2024;37:119-170. doi:10.1016/j.echo.2023.11.015", "doi": "10.1016/j.echo.2023.11.015" }, { "citation": "McNamara PJ, Jain A, El-Khuffash A, et al. Guidelines and recommendations for targeted neonatal echocardiography and cardiac point-of-care ultrasound in the NICU. J Am Soc Echocardiogr 2024;37:171-215. doi:10.1016/j.echo.2023.11.016", "doi": "10.1016/j.echo.2023.11.016" }, { "citation": "Nagueh SF, Sanborn DY, Oh JK, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography and for heart failure with preserved ejection fraction diagnosis: an update from the ASE. J Am Soc Echocardiogr 2025;38:537-569. doi:10.1016/j.echo.2025.03.011", "doi": "10.1016/j.echo.2025.03.011" }, { "citation": "Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the ASE and EACVI. J Am Soc Echocardiogr 2016;29:277-314. doi:10.1016/j.echo.2016.01.011", "doi": "10.1016/j.echo.2016.01.011" }, { "citation": "Nagueh SF, Appleton CP, Gillebert TC, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. J Am Soc Echocardiogr 2009;22:107-133. doi:10.1016/j.echo.2008.11.023", "doi": "10.1016/j.echo.2008.11.023" }, { "citation": "Lopez L, Colan SD, Frommelt PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram. J Am Soc Echocardiogr 2010;23:465-495. doi:10.1016/j.echo.2010.03.019", "doi": "10.1016/j.echo.2010.03.019" }, { "citation": "Mertens L, Seri I, Marek J, et al. Targeted neonatal echocardiography in the neonatal intensive care unit. J Am Soc Echocardiogr 2011;24:1057-1078. doi:10.1016/j.echo.2011.07.014", "doi": "10.1016/j.echo.2011.07.014" }, { "citation": "de Waal K, Petoello E, Crendal E, Phad N. Reference ranges of left ventricular diastolic multimodal ultrasound parameters in stable preterm infants in the early and late NICU admission period. J Perinatol 2025;45:920. doi:10.1038/s41372-025-02278-1", "doi": "10.1038/s41372-025-02278-1" }, { "citation": "Ciarcià M, Malanima MA, Ficial B, et al. Normal ranges of TDI echocardiographic parameters in healthy term and preterm newborns: a systematic review and meta-analysis. Eur J Pediatr 2025;184:551. doi:10.1007/s00431-025-06323-1", "doi": "10.1007/s00431-025-06323-1" }, { "citation": "Di Maria MV, Younoszai AK, Sontag MK, et al. Maturational changes in diastolic longitudinal myocardial velocity in preterm infants. J Am Soc Echocardiogr 2015;28:1045-1052. doi:10.1016/j.echo.2015.04.016", "doi": "10.1016/j.echo.2015.04.016" }, { "citation": "Cantinotti M, Marchese P, Capponi G, et al. Pediatric echocardiographic nomograms: an up-to-date review. J Clin Med 2025;14:5215. doi:10.3390/jcm14155215", "doi": "10.3390/jcm14155215" }, { "citation": "Cantinotti M, Capponi G, Scalese M, et al. Echocardiographic markers of RV diastolic dysfunction in neonates and infants with congenital heart disease. J Clin Med 2025;15:98. doi:10.3390/jcm15010098", "doi": "10.3390/jcm15010098" }, { "citation": "Bhatla P, Nielsen JC, Ko HH, et al. Normal values of left atrial volume in pediatric age group using a validated allometric model. Circ Cardiovasc Imaging 2012;5:791-796. doi:10.1161/CIRCIMAGING.112.974428", "doi": "10.1161/CIRCIMAGING.112.974428" }, { "citation": "McMahon CJ, et al. Circulation 2004;109:1756-1762 (children with HCM; tissue Doppler). doi:10.1161/01.CIR.0000124723.16433.31", "doi": "10.1161/01.CIR.0000124723.16433.31" }, { "citation": "O'Leary PW, Durongpisitkul K, Cordes TM, et al. Diastolic ventricular function in children. Mayo Clin Proc 1998;73:616-628. doi:10.4065/73.7.616", "doi": "10.4065/73.7.616" }, { "citation": "Dragulescu A, Mertens L, Friedberg MK. Interpretation of left ventricular diastolic dysfunction in children with cardiomyopathy by echocardiography: problems and limitations. Circ Cardiovasc Imaging 2013;6:254-261. doi:10.1161/CIRCIMAGING.112.000175", "doi": "10.1161/CIRCIMAGING.112.000175" }, { "citation": "Masutani S, et al. Heart Vessels 2014;29:825-833. doi:10.1007/s00380-013-0422-2", "doi": "10.1007/s00380-013-0422-2" }, { "citation": "Ezon DS, et al. Congenit Heart Dis 2015;10:E203-E209. doi:10.1111/chd.12267", "doi": "10.1111/chd.12267" }, { "citation": "Figueras-Coll M, et al. World J Pediatr Congenit Heart Surg 2015;6:438-442. doi:10.1177/2150135115589999", "doi": "10.1177/2150135115589999" }, { "citation": "Lunze FI, et al. Pediatr Transplant 2019;23:e13543. doi:10.1111/petr.13543", "doi": "10.1111/petr.13543" }, { "citation": "Alfares FA, et al. Cardiol Young 2024;34:1799-1804. doi:10.1017/S1047951124000908", "doi": "10.1017/S1047951124000908" }, { "citation": "Wisotzkey BL, et al. Cardiol Young 2022;32:531-538. doi:10.1017/S104795112100247X", "doi": "10.1017/S104795112100247X" }, { "citation": "Dallaire F, Slorach C, Hui W, et al. Reference values for pulse wave Doppler and tissue Doppler imaging in pediatric echocardiography. Circ Cardiovasc Imaging 2015;8:e002167. doi:10.1161/CIRCIMAGING.114.002167", "doi": "10.1161/CIRCIMAGING.114.002167" }, { "citation": "Roberson DA, Cui W, Chen Z, et al. Annular and septal Doppler tissue imaging in children: normal z-score tables and effects of age, heart rate, and body surface area. J Am Soc Echocardiogr 2007;20:1276-1284. doi:10.1016/j.echo.2007.02.023", "doi": "10.1016/j.echo.2007.02.023" }, { "citation": "Eidem BW, et al. Impact of cardiac growth on Doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 2004;17:212-221. doi:10.1016/j.echo.2003.12.005", "doi": "10.1016/j.echo.2003.12.005" }, { "citation": "Cantinotti M, et al. Nomograms for mitral inflow Doppler and tissue Doppler velocities in Caucasian children. J Cardiol 2016;68:288-299. doi:10.1016/j.jjcc.2015.10.004", "doi": "10.1016/j.jjcc.2015.10.004" } ] }, { "id": "echo-regurgitation", "name": "Echo: Valve Regurgitation", "url": "https://heartcalc.doctorarichai.com/refs/echo-regurgitation", "description": "Grading mitral, aortic, tricuspid and pulmonary regurgitation by echo in children: the ASE pediatric approach, pediatric study cut-offs, the adult ASE 2017 grading tables labelled as adult, and how to tell physiologic from pathologic regurgitation.", "method_url": "https://heartcalc.doctorarichai.com/refs/echo-regurgitation#method", "sources": [ { "citation": "Zoghbi WA, Adams D, Bonow RO, et al. Recommendations for noninvasive evaluation of native valvular regurgitation: a report from the ASE developed in collaboration with the SCMR. J Am Soc Echocardiogr 2017;30:303-371. doi:10.1016/j.echo.2017.01.007", "doi": "10.1016/j.echo.2017.01.007" }, { "citation": "Lopez L, Saurers DL, Barker PCA, et al. Guidelines for performing a comprehensive pediatric transthoracic echocardiogram: recommendations from the ASE. J Am Soc Echocardiogr 2024;37:119-170. doi:10.1016/j.echo.2023.11.015", "doi": "10.1016/j.echo.2023.11.015" }, { "citation": "Lopez L, Colan SD, Frommelt PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram. J Am Soc Echocardiogr 2010;23:465-495. doi:10.1016/j.echo.2010.03.019", "doi": "10.1016/j.echo.2010.03.019" }, { "citation": "Valente AM, Cook S, Festa P, et al. Multimodality imaging guidelines for patients with repaired tetralogy of Fallot: a report from the ASE. J Am Soc Echocardiogr 2014;27:111-141. doi:10.1016/j.echo.2013.11.009", "doi": "10.1016/j.echo.2013.11.009" }, { "citation": "Taub CC, Stainback RF, et al. Guidelines for the standardization of adult echocardiography reporting: recommendations from the ASE. J Am Soc Echocardiogr 2025;38:735-774. doi:10.1016/j.echo.2025.06.001", "doi": "10.1016/j.echo.2025.06.001" }, { "citation": "Mercer-Rosa L, Yang W, Kutty S, et al. Quantifying pulmonary regurgitation and right ventricular function in surgically repaired tetralogy of Fallot. Circ Cardiovasc Imaging 2012;5:637-643. doi:10.1161/CIRCIMAGING.112.972588", "doi": "10.1161/CIRCIMAGING.112.972588" }, { "citation": "Prakash A, Lacro RV, Sleeper LA, et al. Challenges in echocardiographic assessment of mitral regurgitation in children after repair of atrioventricular septal defect. Pediatr Cardiol 2012;33:205-214. doi:10.1007/s00246-011-0107-5", "doi": "10.1007/s00246-011-0107-5" }, { "citation": "Renella P, Aboulhosn J, Lohan DG, et al. Two-dimensional and Doppler echocardiography reliably predict severe pulmonary regurgitation as quantified by cardiac magnetic resonance. J Am Soc Echocardiogr 2010;23:880-886. doi:10.1016/j.echo.2010.05.019", "doi": "10.1016/j.echo.2010.05.019" }, { "citation": "Puchalski MD, Askovich B, Sower CT, et al. Pulmonary regurgitation: determining severity by echocardiography and magnetic resonance imaging. Congenit Heart Dis 2008;3:168-175. doi:10.1111/j.1747-0803.2008.00184.x", "doi": "10.1111/j.1747-0803.2008.00184.x" }, { "citation": "Tani LY, Minich LL, Day RW, et al. Doppler evaluation of aortic regurgitation in children. Am J Cardiol 1997;80:927-931. doi:10.1016/S0002-9149(97)00547-X", "doi": "10.1016/S0002-9149(97)00547-X" }, { "citation": "Ibrahim A, Borrelli N, Krupickova S, et al. Pure aortic regurgitation in pediatric patients. Am J Cardiol 2019;124:1731-1735. doi:10.1016/j.amjcard.2019.08.042", "doi": "10.1016/j.amjcard.2019.08.042" }, { "citation": "Schmitz AJ, et al. Angiology 1997;48:725-734. doi:10.1177/000331979704800809", "doi": "10.1177/000331979704800809" }, { "citation": "Farooqui AF, et al. Prevalence of congenital aortic valve regurgitation in a newborn cohort. Pediatr Cardiol 2026. doi:10.1007/s00246-025-04149-0", "doi": "10.1007/s00246-025-04149-0" }, { "citation": "Brand A, et al. Am Heart J 1992 (doi:10.1016/0002-8703(92)90763-L)", "doi": "10.1016/0002-8703(92)90763-L" }, { "citation": "Thomson JD, et al. Heart 2000 (doi:10.1136/heart.83.2.185)", "doi": "10.1136/heart.83.2.185" }, { "citation": "Lee ST, Lin MH. J Formos Med Assoc 2010 (doi:10.1016/S0929-6646(10)60021-6)", "doi": "10.1016/S0929-6646(10)60021-6" }, { "citation": "Webb RH, et al. J Am Soc Echocardiogr 2015 (doi:10.1016/j.echo.2015.03.012)", "doi": "10.1016/j.echo.2015.03.012" }, { "citation": "World Heart Federation 2012 criteria as reproduced in Marangou J, et al. Glob Heart 2024;19:44. doi:10.5334/gh.1327", "doi": "10.5334/gh.1327" } ] }, { "id": "echo-stenosis", "name": "Echo: Valve Stenosis and Coarctation", "url": "https://heartcalc.doctorarichai.com/refs/echo-stenosis", "description": "Grading aortic, pulmonary, mitral and tricuspid stenosis and coarctation by echo in children: Doppler versus catheter gradients, pediatric pitfalls, AHA 2011 pediatric intervention thresholds, and the adult ASE/EACVI grading tables labelled as adult.", "method_url": "https://heartcalc.doctorarichai.com/refs/echo-stenosis#method", "sources": [ { "citation": "Lopez L, Saurers DL, Barker PCA, et al. Guidelines for performing a comprehensive pediatric transthoracic echocardiogram: recommendations from the ASE. J Am Soc Echocardiogr 2024;37:119-170. doi:10.1016/j.echo.2023.11.015", "doi": "10.1016/j.echo.2023.11.015" }, { "citation": "Lopez L, Colan SD, Frommelt PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram. J Am Soc Echocardiogr 2010;23:465-495. doi:10.1016/j.echo.2010.03.019", "doi": "10.1016/j.echo.2010.03.019" }, { "citation": "Feltes TF, Bacha E, Beekman RH 3rd, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the AHA. Circulation 2011;123:2607-2652. doi:10.1161/CIR.0b013e31821b1f10", "doi": "10.1161/CIR.0b013e31821b1f10" }, { "citation": "Baumgartner H, Hung J, Bermejo J, et al. Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the EACVI and the ASE. J Am Soc Echocardiogr 2017;30:372-392. doi:10.1016/j.echo.2017.02.009", "doi": "10.1016/j.echo.2017.02.009" }, { "citation": "Baumgartner H, Hung J, Bermejo J, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr 2009;22:1-23. doi:10.1016/j.echo.2008.11.029", "doi": "10.1016/j.echo.2008.11.029" }, { "citation": "Gurvitz M, Krieger EV, Fuller S, et al. 2025 ACC/AHA/HRS/ISACHD/SCAI guideline for the management of adults with congenital heart disease. Circulation 2026;153(8):e115-e251 (co-published J Am Coll Cardiol 2026;87(7):822-976). doi:10.1161/CIR.0000000000001402", "doi": "10.1161/CIR.0000000000001402" }, { "citation": "Goldstein SA, Evangelista A, Abbara S, et al. Multimodality imaging of diseases of the thoracic aorta in adults: from the ASE and the EACVI. J Am Soc Echocardiogr 2015;28:119-182. doi:10.1016/j.echo.2014.11.015", "doi": "10.1016/j.echo.2014.11.015" }, { "citation": "Barker PC, et al. J Am Soc Echocardiogr 2002;15:1496-1502. doi:10.1067/mje.2002.126415", "doi": "10.1067/mje.2002.126415" }, { "citation": "Vlahos AP, et al. Pediatr Cardiol 2008;29:507-514. doi:10.1007/s00246-007-9169-9", "doi": "10.1007/s00246-007-9169-9" }, { "citation": "Schlingmann TR, et al. J Am Soc Echocardiogr 2015;28:1410-1417. doi:10.1016/j.echo.2015.08.016", "doi": "10.1016/j.echo.2015.08.016" } ] }, { "id": "echo-prosthetic", "name": "Echo: Prosthetic Valves", "url": "https://heartcalc.doctorarichai.com/refs/echo-prosthetic", "description": "Prosthetic valve echo: the ASE 2024 criteria for normal function, possible and significant stenosis and prosthesis-patient mismatch in the pulmonary, aortic, mitral and tricuspid positions, and every normal Doppler value by valve model and size (Appendix Tables A1-A9), adult-derived tables labelled.", "method_url": "https://heartcalc.doctorarichai.com/refs/echo-prosthetic#method", "sources": [ { "citation": "Zoghbi WA, Jone PN, Chamsi-Pasha MA, et al. Guidelines for the evaluation of prosthetic valve function with cardiovascular imaging: a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr 2024;37:2-63. doi:10.1016/j.echo.2023.10.004", "doi": "10.1016/j.echo.2023.10.004" }, { "citation": "Blauwet LA, Burkhart HM, Dearani JA, et al. Comprehensive echocardiographic assessment of mechanical tricuspid valve prostheses based on early post-implantation echocardiographic studies. J Am Soc Echocardiogr 2011;24(4):414-424. doi:10.1016/j.echo.2010.12.021", "doi": "10.1016/j.echo.2010.12.021" } ] }, { "id": "echo-strain", "name": "Echo: Strain Normal Values", "url": "https://heartcalc.doctorarichai.com/refs/echo-strain", "description": "Normal LV, RV and LA strain by speckle tracking from preterm infants to 21 years: age-band values by platform (Philips QLAB 10.8, TomTec AutoSTRAIN), neonatal reference intervals, pediatric LA strain by age, z-score sources and adult ASE/EACVI limits.", "method_url": "https://heartcalc.doctorarichai.com/refs/echo-strain#method", "sources": [ { "citation": "Cantinotti M, Ramcharan T, Dorobantu DM, McMahon C, et al. Applications of speckle tracking echocardiography in paediatric and congenital heart disease: an expert consensus paper from AEPC Imaging Working Group. Eur Heart J Imaging Methods Pract 2026;4(3):qyag132. doi:10.1093/ehjimp/qyag132", "doi": "10.1093/ehjimp/qyag132" }, { "citation": "Thomas JD, Edvardsen T, Abraham T, et al. Clinical applications of strain echocardiography: a clinical consensus statement from the ASE developed in collaboration with the EACVI. J Am Soc Echocardiogr 2025;38:985-1020. doi:10.1016/j.echo.2025.07.007", "doi": "10.1016/j.echo.2025.07.007" }, { "citation": "Badano LP, Kolias TJ, Muraru D, et al. Standardization of left atrial, right ventricular, and right atrial deformation imaging using two-dimensional speckle tracking echocardiography: a consensus document of the EACVI/ASE/Industry Task Force. Eur Heart J Cardiovasc Imaging 2018;19:591-600. doi:10.1093/ehjci/jey042", "doi": "10.1093/ehjci/jey042" }, { "citation": "El-Khuffash A, Schubert U, Levy PT, et al. Deformation imaging and rotational mechanics in neonates: a guide to image acquisition, measurement, interpretation, and reference values. Pediatr Res 2018;84(Suppl 1):30-45. doi:10.1038/s41390-018-0080-2", "doi": "10.1038/s41390-018-0080-2" }, { "citation": "Romanowicz J, Ferraro AM, Harrington JK, et al. Pediatric normal values and Z score equations for left and right ventricular strain by two-dimensional speckle-tracking echocardiography derived from a large cohort of healthy children. J Am Soc Echocardiogr 2023;36:310-323. doi:10.1016/j.echo.2022.11.006", "doi": "10.1016/j.echo.2022.11.006" }, { "citation": "Dallaire F, Slorach C, Bradley T, et al. Pediatric reference values and Z score equations for left ventricular systolic strain measured by two-dimensional speckle-tracking echocardiography. J Am Soc Echocardiogr 2016;29:786-793. doi:10.1016/j.echo.2016.03.018", "doi": "10.1016/j.echo.2016.03.018" }, { "citation": "Levy PT, El-Khuffash A, Patel MD, et al. Maturational patterns of systolic ventricular deformation mechanics by two-dimensional speckle tracking echocardiography in preterm infants over the first year of age. J Am Soc Echocardiogr 2017;30:685-698. doi:10.1016/j.echo.2017.03.003", "doi": "10.1016/j.echo.2017.03.003" }, { "citation": "Toma D, Toganel R, Fagarasan A, et al. Interobserver agreement and reference intervals for biventricular myocardial deformation in full-term, healthy newborns: a 2D speckle-tracking echocardiography-based strain analysis. Int J Environ Res Public Health 2022;19:8620. doi:10.3390/ijerph19148620", "doi": "10.3390/ijerph19148620" }, { "citation": "Khan U, Omdal TR, Matre K, Greve G. What is left ventricular strain in healthy neonates? A systematic review and meta-analysis. Pediatr Cardiol 2020;41:1-11. doi:10.1007/s00246-019-02219-8", "doi": "10.1007/s00246-019-02219-8" }, { "citation": "Levy PT, Machefsky A, Sanchez AA, et al. Reference ranges of left ventricular strain measures by two-dimensional speckle-tracking echocardiography in children: a systematic review and meta-analysis. J Am Soc Echocardiogr 2016;29:209-225. doi:10.1016/j.echo.2015.11.016", "doi": "10.1016/j.echo.2015.11.016" }, { "citation": "Levy PT, Sanchez Mejia AA, Machefsky A, et al. Normal ranges of right ventricular systolic and diastolic strain measures in children: a systematic review and meta-analysis. J Am Soc Echocardiogr 2014;27:549-560. doi:10.1016/j.echo.2014.01.015", "doi": "10.1016/j.echo.2014.01.015" }, { "citation": "Ficial B, Corsini I, Clemente M, et al. Feasibility, reproducibility and reference ranges of left atrial strain in preterm and term neonates in the first 48 h of life. Diagnostics 2022;12:350. doi:10.3390/diagnostics12020350", "doi": "10.3390/diagnostics12020350" }, { "citation": "Marchese P, Scalese M, Giordano R, et al. Pediatric ranges of normality for 2D speckle-tracking echocardiography atrial strain: differences between p- and r-gating and among new (atrial designed) and conventional (ventricular specific) software's. Echocardiography 2021;38:2025-2031. doi:10.1111/echo.15244", "doi": "10.1111/echo.15244" }, { "citation": "Cantinotti M, Scalese M, Giordano R, et al. Left and right atrial strain in healthy Caucasian children by two-dimensional speckle-tracking echocardiography. J Am Soc Echocardiogr 2019;32:165-168.e3. doi:10.1016/j.echo.2018.10.002", "doi": "10.1016/j.echo.2018.10.002" } ] }, { "id": "echo-ph", "name": "Echo: Pulmonary Hypertension", "url": "https://heartcalc.doctorarichai.com/refs/echo-ph", "description": "Echo assessment of pulmonary hypertension in neonates, infants and children: neonatal signs, pressure estimates, eccentricity index and RV/LV ratio centiles, PAAT and TAPSE normal values by age, cut-offs, risk tables, screening recommendations, and the adult ESC/ASE approach for comparison.", "method_url": "https://heartcalc.doctorarichai.com/refs/echo-ph#method", "sources": [ { "citation": "Ivy D, Rosenzweig EB, Abman SH, et al. Embracing the challenges of neonatal and paediatric pulmonary hypertension. Eur Respir J 2024;64(4):2401345. doi:10.1183/13993003.01345-2024", "doi": "10.1183/13993003.01345-2024" }, { "citation": "Hansmann G, Koestenberger M, Alastalo TP, et al. 2019 updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension: the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). J Heart Lung Transplant 2019;38:879-901. doi:10.1016/j.healun.2019.06.022", "doi": "10.1016/j.healun.2019.06.022" }, { "citation": "Abman SH, Hansmann G, Archer SL, et al. Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society. Circulation 2015;132:2037-2099. doi:10.1161/CIR.0000000000000329", "doi": "10.1161/CIR.0000000000000329" }, { "citation": "Krishnan U, Feinstein JA, Adatia I, et al. Evaluation and management of pulmonary hypertension in children with bronchopulmonary dysplasia. J Pediatr 2017;188:24-34.e1. doi:10.1016/j.jpeds.2017.05.029", "doi": "10.1016/j.jpeds.2017.05.029" }, { "citation": "Hansmann G, Sallmon H, Roehr CC, Kourembanas S, et al. Pulmonary hypertension in bronchopulmonary dysplasia. Pediatr Res 2021;89:446-455. doi:10.1038/s41390-020-0993-4", "doi": "10.1038/s41390-020-0993-4" }, { "citation": "McNamara PJ, Jain A, El-Khuffash A, et al. Guidelines and recommendations for targeted neonatal echocardiography and cardiac point-of-care ultrasound in the NICU: an update from the ASE. J Am Soc Echocardiogr 2024;37:171-215. doi:10.1016/j.echo.2023.11.016", "doi": "10.1016/j.echo.2023.11.016" }, { "citation": "de Boode WP, Singh Y, Molnar Z, et al. Application of neonatologist performed echocardiography in the assessment and management of persistent pulmonary hypertension of the newborn. Pediatr Res 2018;84(Suppl 1):68-77. doi:10.1038/s41390-018-0082-0", "doi": "10.1038/s41390-018-0082-0" }, { "citation": "Koestenberger M, Friedberg MK, Nestaas E, Michel-Behnke I, Hansmann G. Transthoracic echocardiography in the evaluation of pediatric pulmonary hypertension and ventricular dysfunction. Pulm Circ 2016;6:15-29. doi:10.1086/685051", "doi": "10.1086/685051" }, { "citation": "Adult. Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2022;43:3618-3731. doi:10.1093/eurheartj/ehac237", "doi": "10.1093/eurheartj/ehac237" }, { "citation": "Adult. Mukherjee M, Rudski LG, Addetia K, et al. Guidelines for the echocardiographic assessment of the right heart in adults and special considerations in pulmonary hypertension. J Am Soc Echocardiogr 2025;38:141-186. doi:10.1016/j.echo.2025.01.006", "doi": "10.1016/j.echo.2025.01.006" }, { "citation": "Schweintzger S, Kurath-Koller S, Burmas A, et al. Normal echocardiographic reference values of the right ventricular to left ventricular endsystolic diameter ratio and the left ventricular endsystolic eccentricity index in healthy children and in children with pulmonary hypertension. Front Cardiovasc Med 2022;9:950765. doi:10.3389/fcvm.2022.950765", "doi": "10.3389/fcvm.2022.950765" }, { "citation": "Abraham S, Weismann CG. Left ventricular end-systolic eccentricity index for assessment of pulmonary hypertension in infants. Echocardiography 2016;33:910-915. doi:10.1111/echo.13171", "doi": "10.1111/echo.13171" }, { "citation": "Burkett DA, Patel SS, Mertens L, Friedberg MK, Ivy DD. Relationship between left ventricular geometry and invasive hemodynamics in pediatric pulmonary hypertension. Circ Cardiovasc Imaging 2020;13:e009825. doi:10.1161/CIRCIMAGING.119.009825", "doi": "10.1161/CIRCIMAGING.119.009825" }, { "citation": "Jone PN, Hinzman J, Wagner BD, Ivy DD, Younoszai A. Right ventricular to left ventricular diameter ratio at end-systole in evaluating outcomes in children with pulmonary hypertension. J Am Soc Echocardiogr 2014;27:172-178. doi:10.1016/j.echo.2013.10.014", "doi": "10.1016/j.echo.2013.10.014" }, { "citation": "Koestenberger M, Grangl G, Avian A, et al. Normal reference values and z scores of the pulmonary artery acceleration time in children and its importance for the assessment of pulmonary hypertension. Circ Cardiovasc Imaging 2017;10:e005336. doi:10.1161/CIRCIMAGING.116.005336", "doi": "10.1161/CIRCIMAGING.116.005336" }, { "citation": "Levy PT, Patel MD, Groh G, et al. Pulmonary artery acceleration time provides a reliable estimate of invasive pulmonary hemodynamics in children. J Am Soc Echocardiogr 2016;29:1056-1065. doi:10.1016/j.echo.2016.08.013", "doi": "10.1016/j.echo.2016.08.013" }, { "citation": "Patel MD, Breatnach CR, James AT, et al. Echocardiographic assessment of right ventricular afterload in preterm infants: maturational patterns of pulmonary artery acceleration time over the first year of age and implications for pulmonary hypertension. J Am Soc Echocardiogr 2019;32:884-894.e4. doi:10.1016/j.echo.2019.03.015", "doi": "10.1016/j.echo.2019.03.015" }, { "citation": "Koestenberger M, Ravekes W, Everett AD, et al. Right ventricular function in infants, children and adolescents: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 640 healthy patients and calculation of z score values. J Am Soc Echocardiogr 2009;22:715-719. doi:10.1016/j.echo.2009.03.026", "doi": "10.1016/j.echo.2009.03.026" }, { "citation": "Koestenberger M, Nagel B, Ravekes W, et al. Systolic right ventricular function in preterm and term neonates: reference values of the tricuspid annular plane systolic excursion (TAPSE) in 258 patients and calculation of z-score values. Neonatology 2011;100:85-92. doi:10.1159/000322006", "doi": "10.1159/000322006" } ] }, { "id": "echo-single-ventricle", "name": "Echo: Single Ventricle", "url": "https://heartcalc.doctorarichai.com/refs/echo-single-ventricle", "description": "Echo measurements in single-ventricle patients from neonate to Fontan: short-axis and RV fractional area change, area-length volumes, dP/dt, MPI, arch Doppler after Norwood, Fontan fenestration gradient and AV-valve regurgitation, with published single-ventricle cohort values (SVR trial, PHN Fontan studies) and the AHA and ACHD surveillance intervals.", "method_url": "https://heartcalc.doctorarichai.com/refs/echo-single-ventricle#method", "sources": [ { "citation": "Lopez L, Saurers DL, Barker PCA, et al. Guidelines for performing a comprehensive pediatric transthoracic echocardiogram: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr 2024;37:119-170. doi:10.1016/j.echo.2023.11.015", "doi": "10.1016/j.echo.2023.11.015" }, { "citation": "Rychik J, Atz AM, Celermajer DS, et al. Evaluation and management of the child and adult with Fontan circulation: a scientific statement from the American Heart Association. Circulation 2019;140:e234-e284. doi:10.1161/CIR.0000000000000696", "doi": "10.1161/CIR.0000000000000696" }, { "citation": "Gurvitz M, Krieger EV, Fuller S, et al. 2025 ACC/AHA/HRS/ISACHD/SCAI guideline for the management of adults with congenital heart disease. Circulation 2026;153:e115-e251. doi:10.1161/CIR.0000000000001402", "doi": "10.1161/CIR.0000000000001402" }, { "citation": "Feltes TF, Bacha E, Beekman RH 3rd, et al. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 2011;123:2607-2652. doi:10.1161/CIR.0b013e31821b1f10", "doi": "10.1161/CIR.0b013e31821b1f10" }, { "citation": "Simpson J, Lopez L, Acar P, et al. Three-dimensional echocardiography in congenital heart disease: an expert consensus document from the EACVI and the ASE. J Am Soc Echocardiogr 2017;30:1-27. doi:10.1016/j.echo.2016.08.022", "doi": "10.1016/j.echo.2016.08.022" }, { "citation": "Mukherjee M, Rudski LG, Addetia K, et al. Guidelines for the echocardiographic assessment of the right heart in adults and special considerations in pulmonary hypertension. J Am Soc Echocardiogr 2025;38:141-186. doi:10.1016/j.echo.2025.01.006", "doi": "10.1016/j.echo.2025.01.006" }, { "citation": "Baumgartner H, Hung J, Bermejo J, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr 2009;22:1-23. doi:10.1016/j.echo.2008.11.029", "doi": "10.1016/j.echo.2008.11.029" }, { "citation": "Frommelt PC, Guey LT, Minich LL, et al. Does initial shunt type for the Norwood procedure affect echocardiographic measures of cardiac size and function during infancy? The Single Ventricle Reconstruction trial. Circulation 2012;125:2630-2638. doi:10.1161/CIRCULATIONAHA.111.072694", "doi": "10.1161/CIRCULATIONAHA.111.072694" }, { "citation": "Frommelt PC, Gerstenberger E, Cnota JF, et al. Impact of initial shunt type on cardiac size and function in children with single right ventricle anomalies before the Fontan procedure: the Single Ventricle Reconstruction extension trial. J Am Coll Cardiol 2014;64:2026-2035. doi:10.1016/j.jacc.2014.08.033", "doi": "10.1016/j.jacc.2014.08.033" }, { "citation": "Frommelt PC, Hu C, Trachtenberg F, et al. Impact of initial shunt type on echocardiographic indices in children after single right ventricle palliations. Circ Cardiovasc Imaging 2019;12:e007865. doi:10.1161/CIRCIMAGING.118.007865", "doi": "10.1161/CIRCIMAGING.118.007865" }, { "citation": "Hill GD, Frommelt PC, Stelter J, et al. Impact of initial Norwood shunt type on right ventricular deformation: the Single Ventricle Reconstruction trial. J Am Soc Echocardiogr 2015;28:517-521. doi:10.1016/j.echo.2015.01.018", "doi": "10.1016/j.echo.2015.01.018" }, { "citation": "Hill KD, Rhodes JF, Aiyagari R, et al. Intervention for recoarctation in the Single Ventricle Reconstruction trial: incidence, risk, and outcomes. Circulation 2013;128:954-961. doi:10.1161/CIRCULATIONAHA.112.000488", "doi": "10.1161/CIRCULATIONAHA.112.000488" }, { "citation": "Cnota JF, Chowdhury SM, Floh A, et al. Tricuspid regurgitation and impact of surgical valve intervention in the Single Ventricle Reconstruction trial. Pediatr Cardiol 2026;47:3354-3361. doi:10.1007/s00246-025-04122-x", "doi": "10.1007/s00246-025-04122-x" }, { "citation": "Rios R, Ginde S, Saudek D, et al. Quantitative echocardiographic measures in the assessment of single ventricle function post-Fontan: incorporation into routine clinical practice. Echocardiography 2017;34:108-115. doi:10.1111/echo.13408", "doi": "10.1111/echo.13408" }, { "citation": "Di Maria MV, Goldberg DJ, Zak V, et al. Impact of udenafil on echocardiographic indices of single ventricle size and function in FUEL study participants. Circ Cardiovasc Imaging 2022;15:e013676. doi:10.1161/CIRCIMAGING.121.013676", "doi": "10.1161/CIRCIMAGING.121.013676" }, { "citation": "Anderson PA, Sleeper LA, Mahony L, et al. Contemporary outcomes after the Fontan procedure: a Pediatric Heart Network multicenter study. J Am Coll Cardiol 2008;52:85-98. doi:10.1016/j.jacc.2008.01.074", "doi": "10.1016/j.jacc.2008.01.074" }, { "citation": "Margossian R, Schwartz ML, Prakash A, et al. Comparison of echocardiographic and cardiac magnetic resonance imaging measurements of functional single ventricular volumes, mass, and ejection fraction (from the Pediatric Heart Network Fontan Cross-Sectional Study). Am J Cardiol 2009;104:419-428. doi:10.1016/j.amjcard.2009.03.058", "doi": "10.1016/j.amjcard.2009.03.058" }, { "citation": "Margossian R, Zak V, Shillingford AJ, et al. The effect of the superior cavopulmonary anastomosis on ventricular remodeling in infants with single ventricle. J Am Soc Echocardiogr 2017;30:699-707. doi:10.1016/j.echo.2017.03.005", "doi": "10.1016/j.echo.2017.03.005" }, { "citation": "Butts RJ, Chowdhury SM, Buckley J, et al. Comparison of echocardiographic and pressure-volume loop indices of systolic function in patients with single ventricle physiology: a preliminary report. Congenit Heart Dis 2015;10:E17-E24. doi:10.1111/chd.12191", "doi": "10.1111/chd.12191" }, { "citation": "Tei C, Dujardin KS, Hodge DO, et al. Doppler echocardiographic index for assessment of global right ventricular function. J Am Soc Echocardiogr 1996;9:838-847. doi:10.1016/S0894-7317(96)90476-9", "doi": "10.1016/S0894-7317(96)90476-9" }, { "citation": "Bargiggia GS, Bertucci C, Recusani F, et al. A new method for estimating left ventricular dP/dt by continuous wave Doppler-echocardiography: validation studies at cardiac catheterization. Circulation 1989;80:1287-1292. doi:10.1161/01.CIR.80.5.1287", "doi": "10.1161/01.CIR.80.5.1287" }, { "citation": "Sanders EN, Chen JZ, Nissen T, et al. Comparison of echocardiographically-calculated Fontan fenestration gradient and catheter-based measurement. Pediatr Cardiol 2025;46:2047-2053. doi:10.1007/s00246-024-03651-1", "doi": "10.1007/s00246-024-03651-1" }, { "citation": "Sekar P, Border WL, Kimball TR, et al. Aortic arch recoarctation after the Norwood stage I palliation: the comparative accuracy of blood pressure cuff and echocardiographic Doppler gradients in detecting significant obstruction. Congenit Heart Dis 2009;4:440-447. doi:10.1111/j.1747-0803.2009.00350.x", "doi": "10.1111/j.1747-0803.2009.00350.x" }, { "citation": "Eagam M, Loomba RS, Pelech AN, et al. Predicting the need for neoaortic arch intervention in infants with hypoplastic left heart syndrome through the Glenn procedure. Pediatr Cardiol 2017;38:70-76. doi:10.1007/s00246-016-1485-5", "doi": "10.1007/s00246-016-1485-5" }, { "citation": "Wellen SL, Glatz AC, Gillespie MJ, et al. Usefulness of transthoracic echocardiography to accurately diagnose recoarctation of the aorta after the Norwood procedure. Am J Cardiol 2014;114:117-121. doi:10.1016/j.amjcard.2014.04.014", "doi": "10.1016/j.amjcard.2014.04.014" }, { "citation": "Cohen MS, Marino BS, McElhinney DB, et al. Neo-aortic root dilation and valve regurgitation up to 21 years after staged reconstruction for hypoplastic left heart syndrome. J Am Coll Cardiol 2003;42:533-540. doi:10.1016/S0735-1097(03)00715-0", "doi": "10.1016/S0735-1097(03)00715-0" }, { "citation": "Spearman AD, Ginde S, Goot BH, et al. Echocardiographic identification of pulmonary artery flow reversal: an indicator of adverse outcomes in single ventricle physiology. Pediatr Cardiol 2020;41:1632-1638. doi:10.1007/s00246-020-02421-z", "doi": "10.1007/s00246-020-02421-z" } ] }, { "id": "echo-pda", "name": "Echo: PDA Assessment", "url": "https://heartcalc.doctorarichai.com/refs/echo-pda", "description": "Echo assessment of the patent ductus arteriosus in preterm infants: the AAP 2025 suggested hsPDA definition, small/moderate/large shunt markers, the El-Khuffash and Iowa scores, how to measure, and what is known beyond the neonatal period.", "method_url": "https://heartcalc.doctorarichai.com/refs/echo-pda#method", "sources": [ { "citation": "Ambalavanan N, Aucott SW, Salavitabar A, Levy VY; American Academy of Pediatrics Committee on Fetus and Newborn and Section on Cardiology and Cardiac Surgery. Patent ductus arteriosus in preterm infants. Pediatrics 2025;155(5):e2025071425. doi:10.1542/peds.2025-071425", "doi": "10.1542/peds.2025-071425" }, { "citation": "McNamara PJ, Jain A, El-Khuffash A, et al. Guidelines and recommendations for targeted neonatal echocardiography and cardiac point-of-care ultrasound in the NICU: an update from the ASE. J Am Soc Echocardiogr 2024;37:171-215. doi:10.1016/j.echo.2023.11.016", "doi": "10.1016/j.echo.2023.11.016" }, { "citation": "van Laere D, van Overmeire B, Gupta S, et al. Application of NPE in the assessment of a patent ductus arteriosus. Pediatr Res 2018;84(Suppl 1):46-56. doi:10.1038/s41390-018-0077-x", "doi": "10.1038/s41390-018-0077-x" }, { "citation": "McNamara PJ, Sehgal A. Towards rational management of the patent ductus arteriosus: the need for disease staging. Arch Dis Child Fetal Neonatal Ed 2007;92:F424-F427. doi:10.1136/adc.2007.118117", "doi": "10.1136/adc.2007.118117" }, { "citation": "El-Khuffash A, James AT, Corcoran JD, et al. A patent ductus arteriosus severity score predicts chronic lung disease or death before discharge. J Pediatr 2015;167:1354-1361.e2. doi:10.1016/j.jpeds.2015.09.028", "doi": "10.1016/j.jpeds.2015.09.028" }, { "citation": "Brandt C, Mat HD, Bischoff AR, McNamara PJ, Rios DR. Association of low shunt burden from PDA and adverse outcomes in premature infants. J Perinatol 2026;46:364-369. doi:10.1038/s41372-025-02437-4", "doi": "10.1038/s41372-025-02437-4" }, { "citation": "Rios DR, Martins FF, El-Khuffash A, et al. Early role of the atrial-level communication in premature infants with patent ductus arteriosus. J Am Soc Echocardiogr 2021;34:423-432.e1. doi:10.1016/j.echo.2020.11.008", "doi": "10.1016/j.echo.2020.11.008" }, { "citation": "de Freitas Martins F, Ibarra Rios D, Resende MHF, et al. Relationship of patent ductus arteriosus size to echocardiographic markers of shunt volume. J Pediatr 2018;202:50-55.e3. doi:10.1016/j.jpeds.2018.06.045", "doi": "10.1016/j.jpeds.2018.06.045" }, { "citation": "Groves AM, Kuschel CA, Knight DB, Skinner JR. Does retrograde diastolic flow in the descending aorta signify impaired systemic perfusion in preterm infants? Pediatr Res 2008;63:89-94. doi:10.1203/PDR.0b013e31815b4830", "doi": "10.1203/PDR.0b013e31815b4830" }, { "citation": "de Waal K, Phad N, Boyle A. Left atrium function and deformation in very preterm infants with and without volume load. Echocardiography 2018;35:1818-1826. doi:10.1111/echo.14140", "doi": "10.1111/echo.14140" }, { "citation": "Kluckow M, Evans N. Early echocardiographic prediction of symptomatic patent ductus arteriosus in preterm infants undergoing mechanical ventilation. J Pediatr 1995;127:774-779. doi:10.1016/S0022-3476(95)70172-9", "doi": "10.1016/S0022-3476(95)70172-9" }, { "citation": "Iyer P, Evans N. Re-evaluation of the left atrial to aortic root ratio as a marker of patent ductus arteriosus. Arch Dis Child Fetal Neonatal Ed 1994;70:F112-F117. doi:10.1136/fn.70.2.f112", "doi": "10.1136/fn.70.2.f112" }, { "citation": "El Hajjar M, Vaksmann G, Rakza T, Kongolo G, Storme L. Severity of the ductal shunt: a comparison of different markers. Arch Dis Child Fetal Neonatal Ed 2005;90:F419-F422. doi:10.1136/adc.2003.027698", "doi": "10.1136/adc.2003.027698" }, { "citation": "Su BH, Watanabe T, Shimizu M, Yanagisawa M. Echocardiographic assessment of patent ductus arteriosus shunt flow pattern in premature infants. Arch Dis Child Fetal Neonatal Ed 1997;77:F36-F40. doi:10.1136/fn.77.1.f36", "doi": "10.1136/fn.77.1.f36" } ] } ] }