Comprehensive Cardiac Services
St. Christopher’s Section of Cardiology uses several non-invasive tests to diagnose children with potential heart problems and determine the best course of treatment. These procedures include:
- Electrocardiography(ECG/EKG), ambulatory electrocardiography monitoring (Holter monitoring) and transtelephonic event recording, pacemaker monitoring and defibrillator interrogations
- Exercise physiology, cardiopulmonary exercise testing and exercise echocardiography
- Tilt table testing to diagnose neurocardiogenic syncope
- Fetal echocardiography
Electrocardiography (ECG/EKG) Lab
The heart is in the simplest terms a pump made of muscle tissue that requires a source of energy in order to function. Its pumping action comes from a built-in electrical conduction system. An ECG/EKG is a basic non-invasive test performed to determine the rate and rhythm of the heart. During the procedure, an ECG technician places electrodes on your child’s arms, legs and across the chest. When the heart beats, it is recorded onto the graph paper on the ECG machine. ECGs are performed in the Heart Center as well as at our specialty care centers. Our cardiologists interpret the reading as normal or having abnormalities.
Exercise Physiology and Cardiopulmonary Exercise Testing (Stress Testing)
Exercise testing uses a treadmill or a bicycle along with electrocardiographic and blood pressure monitoring to assess the function of a patient’s heart. It may be used for patients with a variety of congenital and acquired heart diseases. Stress tests are performed and monitored by an exercise technologist under the supervision of a pediatric cardiologist.
They can be used to assess ECG changes, investigate blood pressure response to exercise, and test for the presence of exercise-induced arrhythmias, cardiomyopathy and syncope. Exercise tests are performed concurrently with a lung function test, echocardiograms and nuclear medicine scans for certain patients.
Echocardiography (Cardiac Ultrasound)
Echocardiography (ECHO) is a non-invasive (non-radiation) procedure that uses high frequency sound waves to assess the heart’s structure and function. Our experienced pediatric echocardiography technologists perform the studies which are then interpreted by our board-certified pediatric cardiologists. These studies are performed on children of all ages who are at risk for congenital and/or acquired heart disease.
To perform the ECHO or echocardiogram, the technologist uses a small probe called a transducer. To obtain multiple angles of the heart structures, the probe is placed on your child’s chest, abdomen and neck. This transducer emits high-frequency sounds waves that pass through the skin and body tissues. When the sound waves reach the heart the waves bounce (or “echo”) off the heart structures. The transducer then picks up the reflected waves and sends them to a computer where two-dimensional images of the heart walls and valves are then created. During the echocardiogram, Doppler technology is also used during the study to assess the velocity of blood flow in the various structures of the heart.
Fetal echocardiography is an ultrasound of the fetus' heart and is performed on high-risk pregnant women beginning at around 18 to 20 weeks gestation (approximately mid-pregnancy). During a fetal echocardiogram, a probe that transmits and receives sound waves is used to generate real-time, moving images of the fetal heart. A fetal echocardiogram is typically performed when there is a suspicion that the baby may have cardiac disease. A thorough fetal echocardiogram will provide physicians with a complete anatomical description of the fetal heart. It will also allow assessment of cardiac function and identify normal or abnormal cardiac rhythms. The test, which takes approximately one hour, is essentially painless and is performed like a routine obstetrical ultrasound. No special preparations are required. The fetal echocardiogram is performed and interpreted by a cardiologist with special expertise in fetal imaging and cardiac ultrasound. The test is available as an outpatient in one of two pediatric echocardiography laboratories; one located at the main hospital campus in Philadelphia and the second at our St. Chris Specialty Pediatrics office in Abington. Because a board-certified cardiologist performs and reviews the test, the study is interpreted "on the spot," and the results can be shared immediately to determine specialty referrals, and prenatal and postnatal treatment plans. Some cardiac problems, such as arrhythmias, may be able to be treated before the baby is born by administering anti-arrhythmia medications to the mother.
Knowing about a potential heart problem prior to delivery gives the family a chance to learn more about the condition which can help them prepare psychologically for dealing with the extra challenges they may face following birth.
Common indications for performing a fetal echocardiogram include:
- Family history of congenital heart disease
- Previous children born with congenital heart disease
- Suspected chromosomal abnormalities (for example, following amniocentesis)
- Other fetal malformations (seen on a screening obstetric ultrasound)
- Maternal history of diabetes
- Irregularities in the fetal heartbeat.
For more information, please call (215) 427-4820.
St. Christopher's Hospital for Children in Philadelphia has highly qualified experts who are specially trained to work with the individual and unique needs of infants and pediatric patients. Our team is led by C. Igor Mesia, MD, Director, Cardiac Catheterization Laboratory and Attending Cardiologist. To view a list of our specialists, please click here.