If your child has a heart problem, the sooner we can find out what’s going on and start treatment (if needed), the better. Nemours’ advanced pediatric cardiac diagnostic tests are backed by our wealth of pediatric cardiology expertise. From EKGs to exercise tests, diagnostic cardiac catheterizations to echocardiography (echos), our pediatric heart tests can help us pinpoint and address pediatric heart conditions in kids of all ages.
Whether your baby is in utero (still in the womb) or you have an infant, growing child or teen, our team of pediatric cardiac experts provide a variety of ways to see what’s going on with your child’s heart and blood vessels. With the help of our pediatric heart specialists, you can get expert evaluation and treatment of conditions and symptoms, from arrhythmias to chest pain, fainting to congenital heart defects.
Like you, we want to get to the bottom of your child’s heart problem as soon as possible so we can start figuring out how to fix it, if necessary.
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Note: A parent or legal guardian must be with a child for a first visit.
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If your doctor thinks your child may have a heart condition, you can get state-of-the-art pediatric diagnostic heart tests (including fetal heart evaluations) on-site at the Nemours Children’s Hospital (NCH).
Types of Diagnostic Tests & What to Expect
With a highly experienced team of board-certified pediatric cardiologists, nurses, and sonographers, we can help you get the answers you need — right when you need them. We can evaluate, diagnose, and help plan treatment for a wide variety of pediatric heart conditions, from arrhythmias to chest pain, fainting to complex congenital heart defects.
Our pediatric cardiologists have one goal – to diagnose heart conditions as early as possible and get your child treated, if needed, as soon as they can. Depending on your child’s symptoms, your doctor may recommend or order one or more of the following heart tests during your initial visit:
- Electrocardiogram (also called an "EKG" or "ECG"): This test measures the heart’s electrical activity and is completely painless. A series of electrodes (small metal tabs) are simply fixed to your child’s skin in a few locations with tiny sticky papers. Then the information is transferred to a computer, where it’s stored and printed as a graph.
- Holter monitor: This is an EKG that’s performed over a long period of time, usually 24 hours or more. Electrodes are connected to the chest and the wires are attached to a portable EKG recorder. Your child will be encouraged to continue normal daily activities, but must be careful to not get the electrodes wet (that means no swimming, showering, or activities that cause a lot of sweating). There are two kinds of Holter monitoring: continuous recording (when the EKG is on throughout the entire monitoring period) and event monitoring (when data is recorded only when the child feels symptoms and then turns the Holter monitor on).
- Cardiac event monitor: This is a portable EKG monitor that records heart “events” (e.g., palpitations, dizziness, shortness of breath) that may not last long enough to show up on an EKG. The device, worn over a long period of time (typically one month), is activated when symptoms occur, and the data helps us pinpoint the cause and develop a treatment plan, if needed. During monitoring, your child can participate in usual activities.
To evaluate your child’s heart structure and function, we use advanced, noninvasive imaging (also called “medical imaging”) tests. Our sophisticated pediatric cardiology equipment lets us produce precise diagnostic images of the heart so we can figure out exactly what’s going on and create the very best treatment plan for your child.
Echocardiography (or “echo,” for short) is our most frequently used imaging tool. It’s a specialized form of ultrasound that builds a picture of your child’s heart (called an “echocardiogram”) using sound waves. Echocardiograms can be done anywhere within our facility — often right at your child’s bedside — to make the experience as stress-free and comfortable as possible.
Three types of echocardiography are available at Nemours
- Transthoracic echocardiography: This test produces images of your child’s heart from the surface of the chest and upper abdomen. Often, these images are so precise that invasive testing (inserting an instrument into the body) isn’t needed. It can be used to diagnose a heart problem and monitor changes in the heart as your child grows. These studies can be performed easily in both the inpatient and outpatient settings. We also offer 3-D echocardiography, which allows us to visualize the structure of the heart valves and other heart structures in even greater detail.
- Transesophageal echocardiography: Also called a "TEE," this test is performed by inserting a small ultrasound probe into the mouth and through the esophagus (the food pipe that connects the throat with the stomach and lies directly behind the heart). This is often used for older, larger children and gives the best close-up view of some otherwise hidden regions of the heart. It’s extremely useful for obtaining images during surgery and cardiac catheterization.
- Fetal echocardiography: This is an in-depth ultrasound study used to view the structure, function, and rhythm of a baby’s heart while in utero (still in the mother’s womb) – as early as the 16th week of the pregnancy. It’s a highly accurate test that’s able to detect major cardiac conditions and evaluate the heart function of our tiniest patients.
Learn More About Fetal Cardiac Testing From a Family at Nemours Children's Hospital »
Your child’s doctors may also order one or both of these other
- Cardiac magnetic resonance imaging (MRI): An extremely helpful and safe imaging tool, this test doesn’t require inserting anything into the body and does not involve radiation. A pediatric MRI produces strikingly clear, complete pictures of your child’s heart and the blood vessels that connect to the heart. A cardiac MRI allows doctors to analyze the structure and function of the heart, as well as the area surrounding the heart (that are less visible with other diagnostic tools) — specifically the lungs, airways, and the esophagus. Because kids must be completely still for MRI, sedation or anesthesia may be required.
- Cardiovascular computed tomography (CT or CAT scan): By injecting a small amount of contrast agent (or dye) into your child’s circulation (a safe technique), the doctor can get an accurate image of the important blood vessels attached to the heart and identify any abnormalities in the heart and other structures in the chest (such as the lungs and airways) in a matter of seconds. The latest technology rapidly produces pictures of many layers of the heart. And because CTs don’t take very long at all, some smaller children can be evaluated for potential problems without having to be sedated.
Depending on your child’s signs and symptoms and what initial testing reveals, your cardiologist may recommend further diagnostic evaluations such as:
- Myocardial perfusion scan: This test is used to look at blood flow to the heart muscle during rest and stress.
- Lung perfusion scan: In this test, we examine blood flow distribution to the right and left lung.
Many children with critical heart disease are diagnosed while still developing (before birth) or soon after. Thanks to our highly skilled team and advanced technology, most children who are born with a heart condition — even newborns only hours old — can be treated right away.
Advanced Diagnostic Fetal Echocardiography Testing
As early as the 16th week of pregnancy, we can perform fetal echocardiography (fetal “echo”) — an in-depth cardiac ultrasound study of
the structure, function, and rhythm of a baby’s heart while still in the womb. Fetal echocardiography is a critical tool for detecting cardiac conditions, but the true value of this highly-accurate technology is that it allows us to diagnose heart problems very early on — giving your baby the best chance for a healthy future.
Partners in Your Baby’s Care
With early diagnosis, our cardiology team has time to work closely with you, your obstetrician, and specialists to develop a comprehensive treatment plan. This may include planning necessary procedures or medicines to begin immediately after your baby is born and determining the best course for your baby’s ongoing care.
We’ll also introduce you to Nemours pediatric specialists who might care for your newborn. For example, neonatologists in our Level II and Level IIIc Neonatal Intensive Care Unit (NICU), which means we care for newborns and infants up to 2-months-old who require surgery or medical services from our expert subspecialists. So you’ll know your baby’s medical team is in place and ready when you need us most.