Members of the Care Team
- Pediatric Cardiologist – A pediatric cardiologist is a pediatrician who has completed an additional three or more years of training in pediatric cardiology. This training gives a pediatric cardiologist the skills needed to diagnose, treat and manage heart conditions in fetuses, newborns, children and teens.
- Advanced Practice Provider – An advanced practice provider is a registered nurse with a master’s degree that has received advanced training in pediatric cardiology.
- Cardiac Sonographers – A cardiac sonographer uses ultrasound equipment to take advanced pictures of the heart and make measurements. This can help the care team diagnose and treat heart problems.
- Medical Assistant – A medical assistant records vital signs, performs EKG’s, speaks to patients and their families, and helps with various tasks to help diagnose and treat patients.
- ADHD Screening – ADHD screening is a cardiac evaluation for children who have a medical history of cardiac disease and are either currently undergoing, or are being considered for stimulant therapy. The evaluation may include an electrocardiogram (EKG/ECG) to determine if the child’s heart is beating as it should and serve as a baseline for future comparison.
- Cardiac Catheterization – Cardiac catheterization is a test that uses a thin, flexible tube, called a catheter, to check the heart. The catheter is inserted into a blood vessel in the arm, groin or neck and threaded to the heart, enabling a cardiologist to conduct diagnostic testing and treatments.
Echocardiography – Echocardiography is a non-invasive test that uses ultrasound waves to take moving pictures of the heart. This allows the cardiologist to examine structures of the heart and identify any abnormalities.
Electrocardiogram – An electrocardiogram (EKG/ECG) is a non-invasive test that uses electrodes placed on the chest and limbs to measure heart activity.
- Electrophysiology – Electrophysiology is a category of tests cardiologists use to evaluate the electrical activity of the heart to understand where an arrhythmia is coming from.
- Event Monitoring – Event monitoring provides evaluation of arrhythmia abnormalities over a 30-day period of time. This testing allows for assessment of heart rhythm during symptomatic periods.
- Exercise Testing – An exercise test helps the cardiologist find out how well a child\'s heart, lungs and muscles work during exercise. The test can also show if there is a lack of blood flow to the heart as the child does work, and helps the cardiologist know the kind and level of activity that\'s right for the child.
Fetal Echo – Fetal echo is a test that uses ultrasound waves to create moving images of the fetal heart structures, the flow of blood through the heart and the heart rhythm.
Holter Monitoring – Holter monitoring provides 24-hour recordings of cardiac activity to detect and plan treatment of arrhythmia abnormalities.
In Patient Care – Pediatric cardiologists often collaborate with pediatric hospitalists and other pediatric subspecialists in the care and treatment of children who are hospitalized.
Out Patient Care – After hospitalization, a child may be referred to a pediatric cardiologist for additional evaluation or continued treatment.
- Preventative Cardiology – Preventive cardiology care is the comprehensive evaluation of a child’s family history, current medical condition, and activity level to make dietary, exercise and medical recommendations.
Sports Clearance – A sports clearance evaluation is an in-depth assessment of a child’s heart to determine if he or she is at risk of sudden cardiac death. The evaluation includes a review of the child’s medical history and risk factors, as well as an EKG, echocardiogram and/or additional types of testing.
Adults with Congenital Heart Disease – Congenital heart disease (CHD) is a term used to describe a group of problems present at birth that affect the structure of the heart and/or the large vessels near the heart. There are many types of CHD. Some types may be detected before birth and, in some cases, may be treated before birth. Other types are not found until the baby is born, during childhood or in adulthood.
Arrhythmia – Arrhythmia describes problems with the rate or rhythm of the heartbeat that occurs when electrical signals to the heart don’t work properly.
Congenital Heart Disease – Congenital heart disease (CHD) is a term used to describe a group of problems present at birth that affect the structure of the heart and/or the large vessels near the heart. There are many types of CHD. Some types may be detected before birth and, in some cases, may be treated before birth. Other types are not found until the baby is born, during childhood or in adulthood.
Long QT Syndrome – Long QT syndrome is a disorder of the heart’s electrical activity that is either inherited or caused by a medication or condition. Children with long QT syndrome may experience irregular heart rates, or arrhythmias, when exposed to exercise or stress, sudden fainting, seizures or even sudden death.
Cardiomyopathy – Cardiomyopathy is a disease of the heart, causing its muscles to become enlarged, thick or ridged. The heart’s lessened ability to pump blood effectively can cause fluid buildup in other parts of the body. As the disease worsens, the heart becomes weaker, causing irregular heartbeats, or arrhythmias, and heart failure.
Hyperlipidemia – Hyperlipidemia, or high cholesterol, is a condition where abnormally high levels of fats particles, also known as lipids, are found in the blood.
Heart Murmur – Heart murmurs are sounds heard when listening to the heart. They may be innocent (normal) or organic (caused by valve abnormalities or holes in the heart, for example). A physical examination by a pediatric cardiologist, in addition to an electrocardiogram, and in some cases an echocardiogram, will distinguish between innocent and organic murmurs.
Syncope – The most common cause of fainting, benign syncope, is when the body reacts to certain activities (such as standing up), by increasing the heart rate and/or blood pressure. The body then responds to this increase by decreasing the heart rate and/or blood pressure, sometimes causing a child to faint, or feel like they are going to faint.
- Abnormal EKG
- Abnormal fetal echocardiogram
- Chest pain
- High blood pressure
- High cholesterol/hyperlipidemia
- Murmurs or other abnormal heart sounds
- Other medical conditions (such as Down syndrome or Marfan syndrome)
- Passing out (also called syncope)
Who needs to see a pediatric cardiologist?
A patient may be referred to a pediatric cardiologist for a variety of reasons, including:
- Physical exam findings: heart murmur or click, elevated blood pressure, or bluish-purple hue to the skin (cyanosis)
- Family history: parent or sibling with congenital heart disease or sudden death
- Symptoms (with or without exercise): dizziness, fainting, chest pain, rapid, strong or irregular heartbeat (palpitations), difficult or labored breathing
- Suspected electrical abnormalities: slow heart rate, rapid heart rate, irregular heart rate
- Lab test results: elevated cholesterol or triglycerides
- Presence of another disorder or illness that may impact the heart: suspected or established neuromuscular/metabolic disorders, Marfan syndrome
- Ultrasound abnormality during pregnancy
What can I expect at the first visit?
At the first visit, the pediatric cardiologist will conduct a comprehensive evaluation, which will include:
- A physical examination
- Height, weight and blood pressure measurements
- Family history
- Medical history
As part of the evaluation, the pediatric cardiologist may also conduct additional tests to reach a diagnosis. Both the testing recommendations and types of questions that the pediatric cardiologist will emphasize during the medical and family history will depend on the reason for the visit.
High blood pressure
In addition to a routine medical and family history, the pediatric cardiologist will pay close attention to questions related to the patient’s diet and exercise habits.
- Bloodwork/lab tests
In addition to a routine medical and family history, the pediatric cardiologist will pay close attention to questions related to the patient’s diet and exercise habits. It is also helpful to know whether any close relatives had early-onset heart disease (before 55 in males and before 65 in females).
- Exercise test
In addition to a routine medical and family history, the pediatric cardiologist will ask questions related to the patient’s symptoms. For example, when does the pain occur? Does it occur with exercise? How about eating? How often does it happen? Is there anything that makes it better?
- Exercise test
In addition to a routine medical and family history, the pediatric cardiologist will ask about what the patient was doing when he or she passed out, as well as questions related to common causes, such as dehydration, illness, seeing blood or getting up too fast. The pediatric cardiologist will ask how the patient felt immediately before passing out, and whether the symptoms occur with exercise, without exercise, or both.
A murmur is a sound heard by the stethoscope; sometimes, these murmurs represent the normal working of the heart, but sometimes they can represent a problem like a hole or valve narrowing. The pediatric cardiologist may order testing based on the patient’s age, history, or exam.
- Holter monitor
- Event monitor
- Exercise test
The pediatric cardiologist will ask questions related to the patient’s symptoms. For example, when do the palpitations happen? How long do they last? How often do they occur? Do the palpitations occur with or without exercise, or both?
- Adult Congenital Heart Association. Explanations, resources, and a list of clinics for adults with congenital heart disease.
- American Heart Association. News, information, CPR training.
- Centers for Disease Control. Facts, stats, diagrams.
- Little Hearts. National organization with pediatric cardiology news, etc. They also have a parent matching program (matching new parents of children with heart disease to parents of children who have lived with disease).
- Marfan Foundation. Excellent resource on Marfan Syndrome.
- Mended Little Hearts. Advocacy group with an active social media support group.
- The Children’s Heart Foundation. Advocacy group with a very informative website.
- The Pediatric and Congenital Electrophysiology Society. An Informative site for families affected by pediatric arrhythmias. They have a link to find a pediatric EP doctor.