Diagnostic Services

Children's Heart Center Diagnostic Services

The Children's Heart Center diagnostic services are provided in an environment structured for the care of the pediatric, adolescent and fetal patient and their families. These services include:

• Echocardiography
  
  • Two dimensional, Doppler, Color flow
    
  • Transesophageal
    
  • Fetal
  
  
• Electrocardiography
  
  • Electrocardiogram
    
  • Holter monitoring
    
  • Pacemaker monitoring
  
  
• Exercise testing
  
• Cardiac catheterization
  
  • Diagnostic
    
  • Interventional
  
  

Pediatric Echocardiography Laboratory

Echocardiography, also known as cardiac ultrasound, is used to create pictures of the heart and blood vessels as well as demonstrate blood flow. This noninvasive procedure provides pediatric cardiologists with detailed information on the anatomy and function of the heart chambers, valves, veins, arteries and adjacent structures. The echocardiographic exam is customarily performed in a quiet, darkened room with the patient watching television, videotapes or simply resting. The study usually takes 30 minutes and involves no preparation by the patient unless sedation is required. Sedation for an echocardiogram is uncommon but is used in active, younger patients, typically toddlers. Studies are obtained by a pediatric cardiac sonographer who is a technologist specifically trained in pediatric cardiology ultrasound. The studies are reviewed and reported by an attending pediatric cardiologist with unique experience in this subspecialty of Pediatric Cardiology. A report of the study is sent to your Pediatric Cardiologist. Any questions you have at the time of the study will be answered by the attending Pediatric Cardiologist in charge of the laboratory on the day of the examination.

Fetal Cardiology Laboratory

Cardiac ultrasound provides Pediatric Cardiologists and Obstetricians with the opportunity to exam the cardiovascular system of the fetus. Referral for a fetal cardiac ultrasound is usually made by a woman's primary obstetrician because of a finding on a routine obstetrical ultrasound or the patient's family history. Fetal echocardiograms are scheduled after the 17th week of gestation. The study is performed by a pediatric cardiac sonogapher with unique training in fetal cardiac ultrasound. The examination usually takes 40 minutes. The duration of the exam may be longer if the fetus is active or facing in the wrong direction. The study will be reviewed at completion by a Pediatric Cardiology attending and discussed with the mother and father at that time.

It is important to remember that the normal fetal cardiovascular circulation is different than the one we live with after birth. In the fetus the lungs do not function as they do after birth and the placenta is an important part of the fetal circulation. Certain structures in the fetal circulation are expected to change following birth. The hole between the heart's upper chambers (patent foramen ovale) and the blood vessel connecting the main artery of the lungs and main artery of the body (patent ductus arteriosus) that are normally present before birth should spontaneously close in early infancy. The vast majority of infants experience the normal transition from fetal to newborn circulation. The fetal echocardiogram cannot predict the closure of these structures to close and therefore cannot exclude their persistence after birth.

Pediatric Electrophysiology Laboratory

The heart is a mechanical pump and electrical generator. The Pediatric Electrophysiology Laboratory provides services for monitoring the electrical activity of the heart. These services vary in the period time over which they monitor the heart rhythm. The electrocardiogram is performed as a screening procedure for examining the customary electrical activity of the heart. This study involves the placement of stickers on the arms, legs and chest and the recording of the electrical activity of the heart for a period of approximately 10 seconds. It is useful in identifying persistent changes in the electrical activity of the heart but may not identify changes in the heart rhythm which come and go during the course of normal activity.

Pediatric Cardiologist often monitor the rhythm of the heart for longer periods of time, particularly when the patient reports varying episodes of extra heart beats or "palpatations" during the course of a day. A Holter monitor is used to continuously record the heart rhythm over a 24 hour period. This exam involves the placement of stickers on the chest and their connection to a small recording device that the patient wears on his or her belt. Following completion of the 24 hour recording period, the recording device is returned to the Pediatric Electrophysiology Laboratory and the heart rhythm is analyzed. The Pediatric Cardiologist requesting the study will review the results with you.

Pediatric Exercise Laboratory

The Pediatric Exercise Laboratory provides services that examine the electrical activity and function of the heart during activity. The activity in this case is pedaling a stationary bicycle against increasing resistance. The patient wears stickers similar to those used for a Holter monitor and breathes through a mouthpiece. In this manner the heart rhythm and electrical activity as well as the oxygen used and carbon dioxide produced during exercised can be monitored.

Special instructions are provided to guide the patient in preparing for the exercise study. These instructions will be provided when the call is made to schedule the study.

Pediatric Cardiac Catheterization Laboratory

The Pediatric Cardiac Catheterization Laboratory provides diagnostic and therapeutic services for the newborn, child and adolescent with congenital and acquired heart disease. Cardiac catheterization provides Pediatric Cardiologists with important diagnostic information regarding the anatomy and function of the heart that is not available using other technologies. Cardiac catheterization also allows Pediatric Cardiologist's to treat anatomic and electrical abnormalities of the heart that historically required open heart surgery or lifelong medical treatment. Narrowed heart valves and arteries can be opened and holes in the heart closed using catheters introduced through a small needle in a vein or artery.

Cardiac catheterizations are performed in a uniquely configured Pediatric Cardiac Catheterization Laboratory by experienced physicians, nurses and technologists. Patients are customarily admitted to the Schneider Children's Hospital the morning of the procedure and discharged to home the same day or the following morning. All patients receive pre-admission, age-appropriate education to prepare them for their procedure and the recovery that follows.