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By Gershel, Jeffrey C.; Rauch, Daniel A.

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Criteria are i. Short PR interval for age ii. Delta wave iii.

Monitor LMWH with anti-factor Xa levels obtained 4 hours after the dose. 0 units/mL at 4 hours after the last SC injection. Once this is achieved, follow the anti-factor Xa weekly. For a DVT, treat with LMWH for up to 3 months. Cardiology 29 LMWH offers several advantages over UFH, including superior bioavailability, with a longer half-life and dose-independent clearance, which results in a more predictable anticoagulation response. It can be administered sub­ cutaneously with minimal laboratory monitoring and dose adjustment.

The most common causes of CHF in children are congenital heart disease (CHD), cardiomyopathies (including genetic, acquired, inherited metabolic, or muscle disorders; infectious diseases; drugs; toxins; Kawasaki disease; and autoimmune diseases), and myocardial dysfunction after surgical repair of heart defects. Other causes include arrhythmias and cardiac valve disease. Regardless of the etiology of CHF, the resulting pathophysiological syndrome requires immediate attention, supportive care, and prompt cardiology consultation.

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