{ "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, and experimental prototypes for ICU, echo, neonatal, fetal, ECG and clinic use.", "version": "1.0.0", "generated": "2026-10-13", "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 on a page is stored or sent anywhere. 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.", "mcp": { "url": "https://heartcalc.doctorarichai.com/mcp", "tools": [ "calculate_cath_hemodynamics", "calculate_hcm_scd_risk", "calculate_neonatal_bp" ] }, "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, MCP 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", "mcp_tool": "calculate_cath_hemodynamics" }, { "id": "stat", "name": "Surgical Risk (STAT 2020)", "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": "cm", "group_label": "Cardiomyopathy", "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", "mcp_tool": "calculate_hcm_scd_risk" }, { "id": "neonatal-bp", "name": "Neonatal Blood Pressure", "url": "https://heartcalc.doctorarichai.com/neonatal-bp", "status": "verified", "group": "neo", "group_label": "Neonatal", "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", "mcp_tool": "calculate_neonatal_bp" }, { "id": "neonatal-echo", "name": "Neonatal Echo Hemodynamics", "url": "https://heartcalc.doctorarichai.com/neonatal-echo", "status": "experimental", "group": "neo", "group_label": "Neonatal", "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. Post-ligation LVO marker: about 1 hour after surgical PDA ligation.", "method_url": "https://heartcalc.doctorarichai.com/neonatal-echo#method", "inputs": [ { "name": "weight", "label": "Weight", "type": "number", "unit": null, "min": 0, "required": true, "notes": "Unit set by wunit (g or kg)." }, { "name": "wunit", "label": "Weight unit", "type": "radio", "unit": null, "options": [ { "value": "g", "label": "g" }, { "value": "kg", "label": "kg" } ], "required": true, "notes": "No default: choose one." }, { "name": "hr", "label": "Heart rate", "type": "number", "unit": "beats/min", "min": 0, "required": true, "notes": null }, { "name": "gaW", "label": "Gestational age at birth, weeks", "type": "number", "unit": "weeks", "min": 0, "required": false, "notes": null }, { "name": "gaD", "label": "Gestational age at birth, days", "type": "number", "unit": "d", "min": 0, "max": 6, "required": false, "notes": null }, { "name": "hours", "label": "Postnatal age at scan", "type": "number", "unit": "hours", "min": 0, "required": false, "notes": null }, { "name": "aoMm", "label": "Aortic valve diameter", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "aoVti", "label": "Aortic VTI", "type": "number", "unit": "cm", "min": 0, "required": false, "notes": null }, { "name": "paMm", "label": "Pulmonary valve diameter", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "paVti", "label": "Pulmonary VTI", "type": "number", "unit": "cm", "min": 0, "required": false, "notes": null }, { "name": "svcMax", "label": "SVC maximal diameter", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "svcMin", "label": "SVC minimal diameter", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "svcVti", "label": "SVC VTI", "type": "number", "unit": "cm", "min": 0, "required": false, "notes": null }, { "name": "pda", "label": "PDA present on this scan?", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": null }, { "name": "pdaMm", "label": "PDA diameter (narrowest)", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null }, { "name": "vmax", "label": "PDA max velocity", "type": "number", "unit": "m/s", "min": 0, "required": false, "notes": null }, { "name": "aPrime", "label": "LV a′ (TDI)", "type": "number", "unit": "cm/s", "min": 0, "required": false, "notes": null }, { "name": "shunt", "label": "Ductal shunt direction", "type": "radio", "unit": null, "options": [ { "value": "lr", "label": "Left-to-right" }, { "value": "bidir", "label": "Bidirectional / R→L" } ], "required": false, "notes": null }, { "name": "mvE", "label": "Mitral E velocity", "type": "number", "unit": "cm/s", "min": 0, "required": false, "notes": null }, { "name": "ivrt", "label": "IVRT", "type": "number", "unit": "ms", "min": 0, "required": false, "notes": null }, { "name": "pvD", "label": "Pulm. vein D wave", "type": "number", "unit": "cm/s", "min": 0, "required": false, "notes": null }, { "name": "laAo", "label": "LA:Ao ratio", "type": "number", "unit": "ratio", "min": 0, "required": false, "notes": null }, { "name": "dfr", "label": "Diastolic flow reversal in descending aorta, celiac or middle cerebral artery?", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": false, "notes": null }, { "name": "postLig", "label": "Scan about 1 hour after surgical PDA ligation", "type": "checkbox", "unit": null, "required": false, "notes": "Shows the Jain 2012 marker: LV output <200 mL/kg/min." }, { "name": "tapse", "label": "TAPSE", "type": "number", "unit": "mm", "min": 0, "required": false, "notes": null } ], "input_notes": "Each section is reported on its own. 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 against 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, et al. Neonatology 2011;100(1):85-92. doi:10.1159/000322006", "doi": "10.1159/000322006" }, { "citation": "Koestenberger M, et al. 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", "doi": "10.1159/000322006" }, { "citation": "Koestenberger M, et al. J Am Soc Echocardiogr 2009;22:715-9", "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": "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", "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": "experimental", "group": "neo", "group_label": "Neonatal", "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": "neo", "group_label": "Neonatal", "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": "Rhodes 1991 and Colan 2006 scores: neonates with critical valvar aortic stenosis being assessed for biventricular repair, with Boston z scores (the derivation reference). AV valve index (Cohen 1996): unbalanced atrioventricular septal defect. Derived decades ago in single centres; a report of what each model says, 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": "pop", "label": "Neonate with valvar aortic stenosis (critical AS)?", "type": "radio", "unit": null, "options": [ { "value": "no", "label": "No" }, { "value": "yes", "label": "Yes" } ], "required": true, "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": true, "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": true, "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 } ], "input_notes": "Rhodes uses bsa, rootMm, mv1, mv2, lvL, hL (and lvmi). Colan uses bsa, the long axes, annZ, mvZ, efe and zRef. The AV valve index uses lavv and ravv.", "outputs": [ "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": "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": "The threshold criteria and their units are quoted from Oreto L et al., Children 2023 (doi:10.3390/children10050859)", "doi": "10.3390/children10050859" }, { "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" } ], "prefill_example": "https://heartcalc.doctorarichai.com/borderline-lv?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&lavv=1&ravv=1.6" }, { "id": "fetal", "name": "Fetal Echo", "url": "https://heartcalc.doctorarichai.com/fetal", "status": "experimental", "group": "neo", "group_label": "Neonatal", "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: about 15 to 39 weeks; Pasquini 2007 isthmus and duct: about 18 to 37 weeks; 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.", "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 minor (width)", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_lvmaj", "label": "LV major (length)", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_rvmin", "label": "RV minor (width)", "type": "number", "unit": "mm", "required": false, "notes": null }, { "name": "m_rvmaj", "label": "RV major (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 plus gaD; 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" ], "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": "experimental", "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": "experimental", "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": "experimental", "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); Khoury 2009 LV mass/height^2.7 cutoffs apply to children over 9 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 LVH cutoff comparison (over 9 years)" ], "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": "experimental", "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": "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 dilatation" } ], "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": "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": "kawasaki", "name": "Kawasaki Coronary Z-Scores", "url": "https://heartcalc.doctorarichai.com/kawasaki", "status": "experimental", "group": "echo", "group_label": "Echo", "description": "Coronary artery z scores from four published models side by side, with the AHA 2017 classification, a model-disagreement flag and the Son 2019 aneurysm risk score.", "keywords": "kawasaki coronary aneurysm z-score aha kobayashi son", "population": "Children with Kawasaki disease, 0 to 18 years. The headline AHA 2017 class uses the verified PHN and Kobayashi models; Boston and Dallaire are unverified comparisons. 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": "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. The Son score needs baseline, asian and crp.", "outputs": [ "Coronary z scores (LMCA, LAD, RCA, LCx) from PHN, Kobayashi, Boston and Dallaire", "AHA 2017 classification per artery, including the 8 mm rule", "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, et al. Update on diagnosis and management of Kawasaki disease: a scientific statement from the American Heart Association. Circulation 2024;150. doi:10.1161/CIR.0000000000001295", "doi": "10.1161/CIR.0000000000001295" }, { "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&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": "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 / 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", "type": "checkbox", "unit": null, "required": false, "notes": "e.g. VSD or AVSD repair." }, { "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." }, { "name": "tapseZ", "label": "TAPSE z-score from your reference", "type": "number", "unit": "Z", "required": false, "notes": "Optional." } ], "input_notes": "Each marker is reported on its own: TR jet (trV with trUnit, no default, and rap), PAAT (with ageY and hr), eccentricity index (eiMode: two diameters or the EI value), TAPSE (with tapseUnit, no default). The x* checkboxes are Levy exclusions.", "outputs": [ "RVSP from the TR jet with an explicit RA pressure", "Levy 2016 estimates of mPAP, PVR and PVRi from PAAT", "End-systolic eccentricity index against published cut-offs", "TAPSE against reference values" ], "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": "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": "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&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": "experimental", "group": "icu", "group_label": "Cardiac ICU", "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": "Cardiac ICU", "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": "experimental", "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": "experimental", "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. ECG items are scored only without these." }, { "name": "scoreQtc", "label": "Resting QTc for scoring (Bazett)", "type": "number", "unit": "ms", "required": false, "notes": "If blank: use calculated." }, { "name": "rec4", "label": "QTc ≥480 ms at 4th minute of exercise recovery", "type": "checkbox", "unit": null, "required": false, "notes": "1 point." }, { "name": "tdp", "label": "Torsade de pointes", "type": "checkbox", "unit": null, "required": false, "notes": "2 points; not added to syncope." }, { "name": "twa", "label": "T-wave alternans", "type": "checkbox", "unit": null, "required": false, "notes": "1 point." }, { "name": "notched", "label": "Notched T wave in 3 leads", "type": "checkbox", "unit": null, "required": false, "notes": "1 point." }, { "name": "lowHr", "label": "Low heart rate for age", "type": "checkbox", "unit": null, "required": false, "notes": "Resting HR below the 2nd percentile for age; 0.5 point." }, { "name": "deaf", "label": "Congenital deafness", "type": "checkbox", "unit": null, "required": false, "notes": "0.5 point." }, { "name": "syncope", "label": "Syncope", "type": "radio", "unit": null, "options": [ { "value": "none", "label": "None" }, { "value": "nostress", "label": "Without stress" }, { "value": "stress", "label": "With stress" } ], "required": false, "notes": "With stress 2, without stress 1; TdP and syncope are mutually exclusive." }, { "name": "famLqts", "label": "Family member with definite LQTS", "type": "checkbox", "unit": null, "required": false, "notes": "1 point." }, { "name": "famScd", "label": "Unexplained sudden cardiac death below age 30 in immediate family", "type": "checkbox", "unit": null, "required": false, "notes": "0.5 point." }, { "name": "sameMember", "label": "Both family items refer to the same relative", "type": "checkbox", "unit": null, "required": false, "notes": "The same family member cannot be counted in both; only the 1-point item counts." } ], "input_notes": "QT is in milliseconds. rateMode (no default) picks hr (bpm) or rr (preceding RR interval, ms). The Schwartz score uses scoreQtc (blank uses the calculated Bazett QTc) and the history checkboxes and syncope.", "outputs": [ "QTc by Bazett, Fridericia, Framingham and Hodges", "Phan 2015 pediatric +2 SD context (6 years or younger)", "Schwartz 1993-2011 LQTS points and probability category" ], "sources": [ { "citation": "Phan DQ, Silka MJ, Lan YT, Chang RK. Comparison of formulas for calculation of the corrected QT interval in infants and young children. J Pediatr 2015;166(4):960-964.e2. doi:10.1016/j.jpeds.2014.12.037", "doi": "10.1016/j.jpeds.2014.12.037" }, { "citation": "Sagie A, Larson MG, Goldberg RJ, Bengtson JR, Levy D. An improved method for adjusting the QT interval for heart rate (the Framingham Heart Study). Am J Cardiol 1992;70(7):797-801. doi:10.1016/0002-9149(92)90562-d", "doi": "10.1016/0002-9149(92)90562-d" }, { "citation": "Schwartz PJ, Crotti L. QTc behavior during exercise and genetic testing for the long-QT syndrome. 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. Circulation 2009;119(10):e241-e250. doi:10.1161/CIRCULATIONAHA.108.191096", "doi": "10.1161/CIRCULATIONAHA.108.191096" } ], "prefill_example": "https://heartcalc.doctorarichai.com/qtc?ageY=4&sex=male&qt=320&rateMode=hr&hr=115&syncope=stress" }, { "id": "hf", "name": "Pediatric Heart Failure", "url": "https://heartcalc.doctorarichai.com/hf", "status": "experimental", "group": "clinic", "group_label": "Clinic", "description": "NT-proBNP compared with age- and sex-specific upper reference limits for ages 1 to 19 (NHANES, Mu 2023), with the Ross 2012 and NYU PHFI scores described and linked.", "keywords": "heart failure nt-probnp bnp ross nyu phfi", "population": "Children and adolescents 1 to 19 years with an NT-proBNP result (NHANES reference, Roche Elecsys assay; other assays may differ). NT-proBNP only, not BNP. The Ross 2012 and NYU PHFI scores are described and linked, not scored.", "method_url": "https://heartcalc.doctorarichai.com/hf#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": "nt", "label": "NT-proBNP", "type": "number", "unit": null, "min": 0, "required": true, "notes": "Unit follows the unit choice on the page." }, { "name": "unit", "label": "Unit reported by your lab", "type": "radio", "unit": null, "options": [ { "value": "pg/mL", "label": "pg/mL" }, { "value": "ng/L", "label": "ng/L" } ], "required": true, "notes": "pg/mL and ng/L are the same number. pmol/L is a molar unit with a much smaller number and is not accepted here." } ], "input_notes": "unit (pg/mL or ng/L, the same number) has no default; pmol/L and BNP are not accepted.", "outputs": [ "NT-proBNP ratio to the age- and sex-specific 97.5th percentile", "Reference median and upper limit for age and sex" ], "sources": [ { "citation": "Mu S, Echouffo-Tcheugui JB, Ndumele CE, et al. NT-proBNP reference intervals in healthy U.S. children, adolescents, and adults. J Appl Lab Med 2023;8(4):700-712. doi:10.1093/jalm/jfad024", "doi": "10.1093/jalm/jfad024" }, { "citation": "Ross RD. The Ross classification for heart failure in children after 25 years: a review and an age-stratified revision. Pediatr Cardiol 2012;33(8):1295-1300. doi:10.1007/s00246-012-0306-8", "doi": "10.1007/s00246-012-0306-8" }, { "citation": "Connolly D, Rutkowski M, Auslender M, Artman M. The New York University Pediatric Heart Failure Index. J Pediatr 2001;138(5):644-648. doi:10.1067/mpd.2001.114020", "doi": "10.1067/mpd.2001.114020" }, { "citation": "Nir A, Lindinger A, Rauh M, et al. NT-pro-B-type natriuretic peptide in infants and children: reference values based on combined data from four studies. Pediatr Cardiol 2009;30(1):3-8. doi:10.1007/s00246-008-9258-4", "doi": "10.1007/s00246-008-9258-4" } ], "prefill_example": "https://heartcalc.doctorarichai.com/hf?ageY=7&sex=female&nt=820&unit=pg%2FmL" }, { "id": "cpet", "name": "Pediatric CPET", "url": "https://heartcalc.doctorarichai.com/cpet", "status": "experimental", "group": "clinic", "group_label": "Clinic", "description": "Where pediatric exercise reference values come from (Burstein 2021 and others, explained and linked) and percent predicted peak VO2 from a predicted value you bring from a named reference.", "keywords": "exercise test cpet vo2 peak percent predicted", "population": "Children and adolescents having cardiopulmonary exercise testing. The page has no built-in reference equation: it computes percent predicted peak VO2 from a predicted value you bring from a named reference (for example Burstein 2021).", "method_url": "https://heartcalc.doctorarichai.com/cpet#method", "inputs": [ { "name": "meas", "label": "Measured peak VO2", "type": "number", "unit": null, "required": true, "notes": "Unit set by measU." }, { "name": "measU", "label": "Measured peak VO2 unit", "type": "select", "unit": null, "options": [ { "value": "mL/kg/min", "label": "mL/kg/min" }, { "value": "mL/min", "label": "mL/min" }, { "value": "L/min", "label": "L/min" } ], "required": true, "notes": null }, { "name": "pred", "label": "Predicted peak VO2 (from your reference)", "type": "number", "unit": null, "required": true, "notes": "Unit set by predU." }, { "name": "predU", "label": "Predicted peak VO2 unit", "type": "select", "unit": null, "options": [ { "value": "mL/kg/min", "label": "mL/kg/min" }, { "value": "mL/min", "label": "mL/min" }, { "value": "L/min", "label": "L/min" } ], "required": true, "notes": null }, { "name": "kg", "label": "Weight", "type": "number", "unit": "kg", "required": false, "notes": null }, { "name": "refName", "label": "Reference used for predicted", "type": "text", "unit": null, "required": false, "notes": "Example: lab software, Burstein 2021 chart." } ], "input_notes": "measU and predU have no default. Weight (kg) is needed only to convert between mL/min and mL/kg/min.", "outputs": [ "Percent predicted peak VO2", "Unit conversion to mL/kg/min" ], "sources": [ { "citation": "Burstein DS, McBride MG, Min J, et al. Normative values for cardiopulmonary exercise stress testing using ramp cycle ergometry in children and adolescents. J Pediatr 2021;229:61-69.e5. doi:10.1016/j.jpeds.2020.09.018", "doi": "10.1016/j.jpeds.2020.09.018" }, { "citation": "Mylius CF, Krijnen WP, van der Schans CP, Takken T. Peak oxygen uptake reference values for cycle ergometry for the healthy Dutch population: data from the LowLands Fitness Registry. 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" } ] }