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Transthoracic Echocardiography

Echocardiography is an ultrasound of the heart. It is performed for detailed analysis of heart structures. Using a small probe called a transducer , images of the heart are obtained by placing the transducer over the chest wall. Echocardiography allows physicians to detect and assess complex heart diseases in children. Atypical echocardiography study last 30-45 minutes. Echocardiography studies are performed by physicians or sonographers who are experienced in heart diseases in children.

Prenatal Diagnosis of Congenital Heart Diseases

Recent advances in echocardiography (ultrasound) has allowed physicians to accurately detect congenital heart disease while the baby is still inside the womb. The detection of congenital heart disease in utero helps prevent the complications of undiagnosed congenital heart disease and help save lives. Once a fetus is diagnosed with congenital heart disease, our physicians and staff at Georgia Pediatric Cardiology provide medical treatment in utero for affected fetuses and make arrangements for the special cardiac card that the baby will need after birth. We work together with obstetricians, perinatologists, and pediatric cardiac surgeons to ensure optimal pre-natal and post-natal medical and surgical care.

Fetal Echocardiography

Fetal echocardiography is a specific ultrasound test performed during pregnancy to evaluate the heart of the baby. Ituses ultrasound equipment similar to the one which was used by your obstetrician for your first ultrasound except the study provides a detail evaluation o f the heart. A small probe called a transducer (similar to a microphone) is placed on the mother's abdomen and ultrasound images of the baby’s heart are obtained. Fetal echocardiography assesses the heart's structures and function. Fetal echocardiographies are performed by doctors who have special training in heart problems in babies (Pediatric cardiologists).

Although fetal echocardiography can detect most congential heart defects, however, there are subtle defects that may not be detected. Remember, a fetal echocardiogram is examining a heart that may be as small as a grape. The images may not be as clear as they will be once the baby is born. Any diagonosis of congenital heart disease in-utero must be confirmed once the baby is born.

It is not necessary for all pregnancies to receive a fetal echocardiogram. The general prenatal ultrasound which is done early in pregnancy can provide information about the fetal heart and its development.has developed Most fetuses do not require any further testing. Situations in which a fetal echocardiogram may be necessary include, but are not limited to, the following:

• Suspected heart abnormality on a routine ultrasound scan performed by an obstetrician.
• Abnormal fetal heart rhythms.
• A sibling or parent born with a heart defect
• The fetus has been diagnosed with other congenital problems: chromosome abnormalities (e.g. Down Syndrome), kidney malformation, bowel abnormality, lung abnormality
• Maternal illness such as Lupus or Diabetes
• Maternal infections such as Toxoplasmosis, Cytomegalic virus (CMV), Coxsackie, Rubella, Mumps virus, Parvovirus
• Exposure to a drug that is associated with an increased risk of heart defects such as: Lithium, Alcohol, Phenytoin, Valproic Acid, Isotretinoin, Carbamazepine, Trimethadione
• Polydramnios (excess amniotic fluid)
• Syndromes that run in families, such as Tuberous Sclerosis, Marfan syndrome, Noonan syndrome, Glycogen Storage Diseases.

Stress Echocardiography

A stress echocardiography is an ultrasound of the heart at peak exercise. It helps physicians find out how well your heart handles work. It is used to assess movement of the heart as blood pressure and heart rate increeases during exercise.

The main function of the heart is to pump blood to the body. As one exercises the body requires more oxygen and the heart must pump harder. TAs the heart pumps harder, its muscles also require more oxygen and more blood supply. An exercise stress test can show if the blood supply to the heart is normal or not during exercise.

Stress echocardiography is performed to evaluate medical conditions such as coronary artery disease, arrhythmias (irregular heart beats), syncope (fainting), chest pain, exercise tolerance, and complex congenital heartt diseases.

During the test, a patient exercises on the treadmill machine while attached to a heart monitor. Blood pressures, heart rate, electrocardiograms (EKGs) are obtained during the test. Echocardiography images of the heart are obatianed with peak exercise.

Depending on the results of the test, the physician may recommend other tests such as nuclear medicine studies or cadiac catheterizations.

Exercise Stress Test

A exercise stress test helps physicians find out how well your heart handles work. The main function of the heart is to pump blood to the body. As one exercises the body requires more oxygen and the heart must pump harder. As the heart pumps harder, its muscles also require more oxygen and more blood supply. An exercise stress test can show if the blood supply to the heart is normal or not during exercise.

Stress are performed to evaluate medical conditions such as coronary artery disease, arrhythmias (irregular heart beats), syncope (fainting), chest pain, exercise tolerance, and complex congenital heart diseases.

During the stress test, a patient exercises on the treadmill machine while attached to a heart monitor. Blood pressures, heart rate, electrocardiograms (EKGs) are obtained during the test.

Depending on the results of the exercise stress test, the physician may recommend other tests such as exercise echocardiography, nuclear medicine studies, and cardiac catheterizations.

12-Lead Electrocardiography (EKG)

An electrocardiogram (EKG) is a test that provides information to physicians about the electrical system of the heart. During an EKG, leads placed on various locations on the chest and abdomen. A tracing is recorded and printed out on paper. Physicians review the tracings and determines whether it is normal or not. An EKG usually takes five minutes to perform.

24-Hour Holter Monitor

An electrocardiogram (EKG) is a test that provides information to physicians about the electrical system of the heart. A holter monitor is a continuous EKG for 12-24 hours. It allows physicians to evaluate the electrical system of the heart for 12-24 hours continuously. Two to three leads are usually placed on the patient chest and these leads are connected to a small box. Patient performs their normal activities including exercise while the test is being done. It is recommended that the patient document its activities while wearing the holter monitor.

Cardiac Event Monitor

The Cardiac Event Monitor is used to physicians detect abnormal or irregular heart rhythms. The device record the cardiac rhythm (electrical activity of the heart) when the appropriate button is pushed. Patients are encouraged to push the button as soon as they develop the symptoms for which they are being evaluated. These symptoms may include: Dizziness, weakness, palpitations (heart racing).

The monitor is equipped with a computer that stores the heart rate and rhythm and sent it to the doctors to review. The monitor is about the size of a deck of cards. The monitor can be worn for about a month and can be taken off for baths.

Tilt Table Test

A tilt table test is a special test which is performed to assess for causes of syncope (fainting). The test is designed to determine how the body regulate blood pressure with changes in position. Patients who have fainted because of sudden drop in blood pressure may benefit from a tilt table test. Tilt table test requires cardiac monitoring for the duration of the tests. In addition, intravenous lines (IVs) are placed at the beginning of the test. Certain cardiac medication may be used during the test. It is recommended that patients fast for 6-8 hours prior to the test.

A positive test suggests neurocardiac syncope (conditions that lead to rapid drop in blood pressure are the cause of fainting) and provide physicians with information needed for treatment of the fainting spells.