Paediatric Echocardiogram

A pediatric echocardiogram is a specialized ultrasound test performed on children under the age of 16. Sound waves create images of the heart to help diagnose congenital heart defects. It gives a detailed view of the heart and does not expose the children to radiation.

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It is performed like a standard transthoracic echocardiogram (echo) in an adult, using a high-frequency probe to produce images.

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Let us know in detail how we should prepare a child for the echocardiogram test, its significance, and more.

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Types of Echocardiography and how they’re done:-

Echocardiography is an imaging test that creates images using sound waves. To create images in two ways.

• Transthoracic Echocardiogram (TTE)
  
  • A handheld probe, called a transducer, is moved across the chest around the heart. The transducer sends and receives sound waves that are converted into images on the monitor.
• Transesophageal echocardiogram
  
  • By this method, the transducer is passed down the esophagus, from the throat to the stomach. It provides a detailed image of the heart, as the esophagus lies ahead of it.

Most echocardiography is 2D, while the others include.

• Doppler, which shows the blood flowing through the heart.
• Color Doppler, which shows color images for a better view of blood flow.
• 3D which gives the 3D view of heart.
• Stress echocardiography, which shows the heart under stress from medicine or exercise.

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Why is an echocardiogram recommended?

An echocardiogram is a crucial imaging test used to diagnose heart problems in infants and young children classified under:-

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Congenital:-

To check for

• Family history of congenital heart disease
• Signs or symptoms of a heart problem
  
  • Presence of blue discoloration of skin
  • Heart murmur
  • Abnormal heart results

Acquired

• Infection
• High blood pressure
• Irregular heartbeats

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Uses of an echocardiogram in children

An echocardiogram helps assess the structure and function of the heart's chambers, valves, and surrounding blood vessels.

• It assesses the pumping action of the heart
• It helps to measure the size of the chamber and the wall thickness
• The size of the surrounding blood vessels when they arise from the heart chamber
• Detect structural abnormalities like holes between chambers, fluid in the lining of the heart, a growth or tumor around the heart
• It helps to detect any leaky or narrowed heart valves

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Performing an Echocardiogram:-

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Preparing before the test

Before the procedure, take the following steps and prepare the child

• Do not let the child eat or drink anything before a transesophageal echocardiogram (TEE)
• Do not apply lotions, creams, or oils on the skin of the child
• Explain the test to the child in detail so that they are not scared and can remain still during the test
• Children below the age of seven years may require sedation to keep them still, so that clear pictures can be taken
• Try distraction techniques with children under four years of age; let them watch a video or hold a toy.

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During the test

Your child may require sedation, but do you know why?

During the procedure, he needs to lie still, and so sedation is advised. Also, if he is undergoing TEE, he needs to be sedated.

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The procedure

• Small electrodes with wires are placed on the child’s chest to detect the heartbeat during the test.
• A probe with gel is gently moved over the child’s chest. The probe sends and receives sound waves to create images on the monitor.
• The toughest part of the test is capturing clear pictures, as the child often moves, either due to age or medical condition.
• The test takes 30-40 minutes to complete if the child is cooperative and lies still.

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After the test

After the test, all the electrodes and wires are removed, and if the child has been sedated, you are asked to wait till he recovers completely and can walk, which often takes some time.

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Safety and risks of an echocardiogram

It is a non-invasive procedure that does not pierce the skin. It is a safe procedure because it uses sound waves, which have no side effects.  Unlike other tests, it does not use any ionizing radiation, as in CT and X-ray.

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Transesophageal echocardiography is a minimally invasive procedure that may be associated with a sore throat and potential injury to the esophagus during or after the test. It also requires sedation. 

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Alternatives to an echocardiogram

X-rays, CT scans, and MRIs reveal the structure of the child’s heart, but an echocardiogram is the only test that shows the heart functioning.

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Having an echo also avoids other diagnostic tests, which are invasive.

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Conclusion

Pediatric echocardiography is a routine cardiac evaluation of children who might be suffering from a heart disease. It can be done repeatedly. Early detection and treatment of heart conditions prevent serious complications and improve a child’s health and quality of life.