Preceptor: Colin Phoon, MPhil, MD
Course Code: 13-02
Contact: Lakesha Baker, lakesha.baker@nyulangone.org
Telephone: 212-263-8111

Prerequisites: Pediatrics Clerkship

Description

Students are exposed to the entire range of congenital and acquired heart disease in fetuses, infants, children, adolescents, and young adults. The main objective of the elective rotation is to provide the student with a basic understanding of pathophysiology, diagnosis and management of common forms of congenital and pediatric heart disease. Students will attend pediatric cardiology outpatient clinics, participate in teaching rounds, and observe procedures such as diagnostic and interventional cardiac catheterization, invasive electrophysiology testing, echocardiography, and cardiac surgical procedures. Weekly conferences include an interdisciplinary cardiac catheterization-surgical conference; additional conferences are optional.

Objectives of the Elective

The student is expected to learn:

1. Essentials of cardiovascular development and correlation of cardiac disorders with genetic syndromes. This includes applied cardiac physiology of fetal, transitional, neonatal, and adult circulation.
2. Pediatric cardiovascular examination, including appropriate diagnostic evaluation of children with murmurs (innocent versus pathological).
3. Common congenital heart defects that result in left-to-right shunts. These include ventricular septal defect, patent ductus arteriosus, atrial septal defect, and AV canal/AV septal defect (endocardial cushion defect).
4. Common cyanotic congenital heart defects. These include tetralogy of Fallot, transposition of the great arteries, tricuspid atresia, truncus arteriosus, pulmonary atresia, total anomalous pulmonary venous connection and hypoplastic left heart syndrome.
5. Common obstructive cardiac lesions such as aortic stenosis, coarctation of the aortic, interrupted aortic arc, and pulmonary stenosis.
6. Pathophysiology and basic principles of cardiac failure.
7. Common acquired pediatric heart diseases, including Kawasaki disease, rheumatic heart disease, viral myocarditis, infectious endocarditis, the cardiomyopathies, and systemic hypertension.
8. Interpretation of pediatric ECG's, and diagnostic and therapeutic approach to common pediatric dysrhythmias (including genetic ion channelopathies).
9. Common surgical procedures for congenital heart disease and the basic principles of pre-and post-operative care.
10. Basic principles of echocardiography and its uses and limitations.
11. Acquisition of clinical skills and medical knowledge is emphasized.

Key Responsibilities of the Student While on Elective

Pediatric Cardiology clinic. To maximize the clinical learning experience, the clinic at Bellevue Hospital takes precedence over other clinical activities unless prior arrangements are made with the Pediatric Cardiology attending. The student will also see patients with pediatric cardiology attendings during their office hours at our Faculty Practice 32nd Street offices. Clinical skills, pediatric EKG interpretation, and basic management of pediatric heart disease will be emphasized.

Congenital Cardiovascular Care Unit (CCVCU) rounds on pre-/post-operative cardiac patients (also NICU, PICU). Not only does this offer an excellent opportunity to observe dynamic changes in the cardiovascular system, but allows participation in the care of complex patients in an intensive care situation.

Pediatric Cardiology consultation and in-patient service. The student may follow 1-2 patients, and should keep abreast of changes in the patient's condition and know current laboratory, chest x-ray, ECG findings. This will expedite discussion and one’s educational experience when the patient is presented to the attending.

Cardiac catheterization and cardiac surgery. Observation of a couple cases is encouraged, since an understanding of invasive hemodynamic evaluation and assessment of cardiac anatomy, and principles of heart surgery, will be useful in understanding cardiac pathophysiology and the changes that can be anticipated with medical and surgical intervention.

Didactic Program

Students can avail themselves of the following: Cardiac Catheterization-Surgical Conference (required), CCVCU CT Surgery Walk Rounds, Bellevue Cardiology Pre- and Post-Clinic Conference; (optional) Journal Club, EP Conference, Echo Conference.

The student will be expected to present topics relevant to patients on the Cardiology service or of interest, as informal 10-15 minute talks.

Method of Evaluation

The Director of the Pediatric Cardiology elective, Dr. Phoon, compiles feedback from the faculty and fellows for the detailed overall evaluation. Students from outside institutions should make sure that Dr. Phoon receives their school's evaluation forms by the end of the rotation.

Scheduling Information

Months Offered: All Year except Aug, Oct-Nov

Report To: Usually, 8:00 a.m., Tisch Hospital CCVCU (Monday morning rounds, 15E); alternative venue, 160 East 32nd Street, 2nd floor (Faculty Practice offices in the NYU Fink Children's Ambulatory Care Center). Fellow on-call pager: (917) 857-3207. If you are a visiting student, you will need to go to the Student Registrar’s office first; see additional instructions.

Students Per Period: 1

Duration: 4 Weeks

NOTE: Dr. Phoon provides a detailed course syllabus with schedules, and a package of articles for each trainee at the start of the rotation. Students should contact Dr. Phoon several days prior to starting the elective to obtain educational packet, colin.phoon@nyulangone.org.