Pediatric Rounds On the Pulse of Pediatric Cardiology

When Valerie Curren was considering options for medical school, she was drawn to the Royal College of Surgeons in Dublin, Ireland, in part because the college emphasizes the art of the physical exam.

Now, as a new member of the pediatric cardiology team at Johns Hopkins Children’s Center, Curren is sharing the wisdom she gained with medical trainees at the hospital, where she is involved in proctoring exams that are used to assess trainees’ clinical skills, such as taking a medical history, performing a physical exam and counseling patients.

“The art of the bedside exam is so important, especially in cardiology, because your history and physical exam tell you everything you need to know,” says Curren, who joined the Blalock-Taussig-Thomas Pediatric and Congenital Heart Center in Fall 2022. “The cardiac exam, which encompasses everything from overall appearance, to the subtleties of [patients’] murmurs, how they are breathing, and any scars or rashes — tells you so much about a patient, sometimes far more than looking through their computer chart.

“As the electronic health record becomes a big focus of our daily activities and as American medical trainee exams [have moved to] computerized multiple-choice formats, it is even more important to incorporate bedside teaching with  trainees,” she adds.

Curren is serving as interim director of the inpatient cardiology unit. She cares for children with all types of heart disease, from post-operative patients following surgery to children with heart conditions admitted to the hospital with acute illness. She also sees patients in outpatient clinics at the East Baltimore campus and Johns Hopkins’ clinics in Frederick and Rockville, Maryland.

In addition, Curren will see patients in a new Fontan Clinic to be launched on the East Baltimore campus this fall. The clinic will be designed to monitor the health of children born with a single heart ventricle instead of two, who have undergone a series of heart surgeries, concluding with a Fontan procedure to improve the flow of blood and oxygen through the heart and out to the body.

“There’s a unique subset of our congenital heart disease population who end up with a Fontan and it comes with its own host of issues that need special attention,” Curren says. “We work to set them up for success when they’re children and then transition them to our adult congenital heart disease (CHD) team when they’re older.” 

As part of her interest in quality improvement initiatives, Curren is helping to develop a simulation curriculum to enact emergency cardiac scenarios with nursing staff members and pediatric residents in the inpatient unit.

Curren advocates for children in other ways. She has served as a volunteer physician for one-week camps for children and teens with heart conditions, and participated in advocacy days for the nonprofit patient support organization Conquering CHD, where she has lobbied legislators to support congenital heart disease research. “Our patients don’t have a voting voice,” she says, “so it’s particularly important to help give them a voice for issues that are important.”