How is a children's echocardiogram performed?

The question that arises for many families is whether the echo of children's heart is the same as the echo of adults or is it different? How is this test done and is the child bothered during this test? These and other common questions are answered in this article.

How is this test done and is the child bothered during this test? These and other common questions are answered in this article.

What is echocardiography for children?

An echocardiogram (“echo”) is an ultrasound test or examination that uses sound waves to view the heart. This test is safe, painless and without radiation. During the procedure, images of the baby's heart can be seen on a small monitor. Echocardiography is similar to ultrasound that many women do before the birth of a child. However, echo is specifically focused on the heart and cardiac blood vessels.

How is echocardiography of children performed?

The child will be placed on one side on the hospital bed in the examination room. Many test rooms are equipped with televisions to keep the child entertained. The child's clothes should be removed from the waist and he can wear a medical gown. To improve the quality of children's heart echo images, a colorless and warm gel is applied to the skin on the chest area where the heart is located. The transducer, a small device like a microphone, is placed on the gel and skin. The transducer uses sound waves to take pictures of different parts of the baby's heart. The transducer can be moved to obtain images on the chest, abdomen and neck area. The sounds you may hear from the echo machine are the sounds of blood flowing from one chamber to another. Valves open or close as blood moves through the heart. The colors you see on the screen. They are not the color of blood. Colors tell us in which direction the blood flows. The red color indicates that the blood is flowing towards the transducer. The blue color indicates that the blood is flowing in the opposite direction of the transducer. The child may feel discomfort from the pressure of the transducer. But the doctor can reduce this pain and sensitivity with his expertise. A computer interprets the information from the transducer to display an image of the heart on the screen. This image is recorded in a digital storage system so that the pediatric cardiologist can measure and check it.

Types of echocardiography in children

In general, there are two methods of echocardiography in children. Transthoracic and esophageal terrace ### Transthoracic Transthoracic or echo from the chest, which is the same as the usual echoes that are performed in offices, clinics and other medical centers. Its application is very wide, from the first steps in the diagnosis of heart diseases on an outpatient basis to the use in special departments of children and infants, and even the post-operative investigations of heart surgeries are carried out from the time of leaving the operating room to the years after the operation to follow up recovery and postoperative complications. ### Transesophageal Transesophageal or echo is through the esophagus. In this method, like an endoscopy, a probe or a device transducer is inserted into the esophagus through the mouth, and heart images are checked in the vicinity of the heart through the esophagus wall. This echo method is only done in special cases; For example, in cases where the exact diagnosis has not yet been determined with transthoracic echo, or in cases where echo from the chest is practically impossible during special surgeries, the heart is checked through the esophagus. This procedure is performed only in well-equipped hospital centers and by experienced pediatric heart specialists in the operating room. During this type of echo, the child is anesthetized by anesthesiologists. Anesthesiologists monitor the child's vital signs and condition from the beginning to the end. Related article When is ECG prescribed in children?

Use cases of pediatric echo

Echocardiography is usually the best test to show the structure and function of heart components. This test is used to measure the size and thickness of the heart chambers and how the heart copes with pumping blood through the heart valves. It can also detect structural abnormalities of the heart (holes between the chambers, fluid around the heart, mass inside the heart, etc.) and show the shape, movement, narrowness or backward flow of the valves.

Preparing the child

If your child is 4 years old or younger, they may need to be sedated for the echo. A mild sleep medication is used, which is usually taken orally. The child's stomach must be empty before receiving sedatives. You should also follow the instructions below. These instructions are:

- **Babies aged 6 to 36 months:** Do not consume milk or solids six hours before the scheduled operation - **Patients older than 36 months:** Do not consume any milk or solids for eight hours before the planned procedure

If a child is going to receive sedation; You should do your best to keep the child awake before the test, and delaying the child's sleep before the test will help him fall asleep faster with sedation. Children older than 4 years usually do not need sedation in pediatric echocardiography. If an older child requires sedation, the test may be performed in the operating room with anesthesia support. If children do not receive sedation, they may eat and do their normal activities immediately after the test; Unless you are told.

Who performs and interprets the echo?

Also, the **superspecialist in children's heart diseases** can interpret this test and inform the parents about the treatment methods if there is a disease.

This action has no risk in terms of radiation or effects caused by sound. Also, considering that during the echo, the probe or transducer of the device has only skin contact with the child's chest. This skin contact does not cause any complications for the child. In a special type of echo called children's esophageal echo, which is only performed in hospital centers. When the child is under anesthesia, special probes are used. which, like an endoscope, enters the esophagus through the mouth and where the esophagus and the heart are adjacent. Images of the heart are checked through the wall of the esophagus. In this method, taking into account that it is performed only by experienced pediatric cardiologists and in the presence of an anesthetist, echocardiography is performed. The risk is much lower.

They are used for cases requiring CT scan, ultrasound and MRI... these drugs are accepted and standardized for use in children all over the world. They have minimal complications in children. Most of these drugs have a short duration of effect. The child is always discharged from the clinic or hospital after the sleepiness and the effects of the medicine are removed.

How long does echocardiography take?

It takes a long time. If a child receives sedation for study. It should be as long as the nurse or doctor feels. The child is ready to leave the hospital. Stay there (usually about 30 to 60 minutes after waking up).

How do we know about the test results?

Your fetal and pediatric cardiologist can. Check the results of the children's echocardiogram immediately and report the results to you before you leave. The results can be requested from the performing doctor within 24 hours after the test. Of course, this amount depends on the treatment center. For further study, you can use the following articles.

https://kidshealth.org/en/parents/echo.html https://www.cincinnatichildrens.org/health/e/echo