Children's heart ailments handled with care on 'ER'

Now a nonprofit organization, the camp offers a summer camp on Catalina Island for children ages 7 to 17 with heart disease. "Most children who have had open-heart surgery are leading normal lives without restriction," Shannon says. That's not to say problems can't occur. The real camp is prepared for evacuation with boats and a helicopter service on standby, Knight says.

Tetralogy of Fallot and hypoplastic (underdeveloped) heart are described accurately, and campers who have overcome such problems can do well at these camps, even exercising vigorously. Hypoplastic heart can be successfully treated with the temporary procedures that the show describes, followed by heart transplant. But the Blalock-Taussig shunt mentioned on the show would have been mostly obsolete since before Vera was born. It's been replaced by a repair of the hole in the heart (ventricular septal defect) and opening of the outflow tract -- the main path from the right side of the heart to the lungs, says Dr. Ann Dubin, director of the pediatric arrhythmia service at the Lucile Packard Children's Hospital of Stanford University.

As for the defibrillator, many people wrongly fear they can be shocked by someone else's device. But the low-energy shock is delivered directly to the heart and isn't transmitted all the way to the skin, points out Joe Sachs, an emergency room physician and executive producer of the show.

The episode also correctly portrays the fact that a defibrillator -- which allows for a specific range of heart beats per minute -- may be set with a high end that's too low, and thus be triggered by exercise. The ideal trigger setting for a child is 200 to 230 beats per minute, Dubin says, "but the child could generally return right to camp and would not need to remain in the hospital."

Shannon says most children who get heart transplants often will live for more than 10 years before requiring second hearts. They can exercise vigorously as long as they are properly supervised.

"ER," devoting one of its final episodes to this real-world camp and using 60 actual campers as extras in the show, is ending its 15-year run in the right spirit.

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Siegel is an associate professor of medicine at New York University's School of Medicine. marc@doctorsiegel.com