Pediatric Cardiology Services
All four of our offices offer full pediatric cardiology services including:
Pediatric Cardiology Consultation
Electrocardiogram and heart rhythm-strips
2-Dimensional echocardiograms with Doppler (transthoracic)
24 hour Holter monitors
Fetal echocardiography (Encino and Thousand Oaks offices only)
We provide the following hospital based services to our patients:
Fetal Cardiology Consultation, fetal echocardiography, diagnosis and treatment of fetal arrhythmias, and follow-up visits
Pediatric Cardiology Consultation (including care in the emergency department,inpatient unit, newborn nursery, NICU, PICU, and Cardiac ICU)
Consultation with Pediatric Cardiac Surgeons
2-Dimensional Echocardiograms with Doppler (transthoracic)
Exercise Stress Tests
Diagnostic Cardiac Catheterization and Angiography
Interventional Cardiac Catheterization
Pediatric Cardiology Consultation
The first office visit, or consultation, is usually made upon the recommendation from your child’s doctor. The consultation includes a thorough history and cardiac examination and any tests that the cardiologist feels that are necessary such as an electrocardiogram (EKG), echocardiogram, or 24 hour Holter monitor. Your child’s cardiologist will spend time with you and your child in their office explaining the diagnosis and answering your questions. Sometimes no treatment or follow-up is needed. In other cases, understanding a heart problem in your child is a difficult and trying task. Please be assured that the cardiologist will spend as much time as is necessary to answer your questions. We also encourage parents to return for repeat conferences if other questions arise after. If a repeat visit is recommended, an appointment can usually be arranged with your cardiologist before leaving the office. Your cardiologist will write a comprehensive report and send it to your child’s primary doctor. At PCMA, one of our pediatric cardiologists will always be on call for your family and your child’s doctor 24 hours per day, every day of the year.
Electrocardiogram (ECG or EKG)
An EKG records the electrical work of the heart on graph paper. It gives information about the rhythm of the heart, the size of the chambers of the heart and the amount of blood going to the heart muscle itself. An EKG is a painless test and takes only a few minutes to complete. It is performed by placing small sensors (electrodes) on your child’s wrists, ankles, and chest. The most accurate EKG is obtained while your child is lying quietly on the examination table. If your child is anxious, you may help comfort him by holding his hand or talking with him.
2-Dimensional Echocardiography with Doppler
An ECHO creates a moving picture of your child’s heart by using high frequency (ultrasound) sound waves.
A small microphone-like instrument (transducer) covered with a jelly substance is moved slowly over the child’s chest. The ECHO produces the picture of the beating heart on a TV screen. The equipment also can show the direction of the blood flow through the heart. The ECHO is painless except for the feeling of slight pressure as the transducer is moved over the chest.
Your child needs to lie quietly on the examination table during the test. We offer movies that your child can watch to occupy their time. To improve the quality of the picture on the screen, the ECHO is done in a dimly lit room. An echo lasts approximately 20 minutes.
The sonographer will try to complete the ECHO as quickly as possible. Parents may remain with their child during the test. The ECHO enables the cardiologist to obtain valuable information about the heart’s structure and function.
This portable monitor enables an EKG to be recorded for 24 hours. It is worn by your child at home or school and during sleep.
The purpose of the monitor is to determine the heart’s rate and rhythm during normal activities. To attach the monitor, several small stick-on patches are placed on the chest.
The recording device, approximately the size of a small radio, is worn on a belt or shoulder strap. You also will be given a diary. While your child is wearing the monitor, it is important for you to record any symptoms, change of activity or other unusual events in the diary.
This information, along with the EKG pattern, will be studied by the cardiologist to determine how the heart functions during your child’s daily routine.
An event monitor is a small device used to record abnormalities of the heart’s rate or rhythm (arrhythmia). We use this type of device when the child’s symptoms occur infrequently. It is the size of a thick credit card or iPod and is placed on the chest for 30 seconds whenever the child feels the heart is beating unusually. The device records the EKG pattern which is then transmitted to us by phone. An event monitor is used at home for one month.
This is a small probe that is wrapped around a finger or toe to measure the oxygen content of your child’s blood. It is painless and easy to use.
Your child’s cardiologist will meet with your family, oftentimes after office hours, to discuss a recent diagnosis, an upcoming procedure or surgery, or to discuss a prenatal diagnosis of congenital heart disease. Parents often choose to meet with their cardiologist without the child in order to minimize the distractions. Please contact our office to schedule a family conference at (818) 784-6269.
Exercise Stress Test
Exercise stress testing determines how the heart works and adjusts to different levels of activity. It is done in a special room in a hospital equipped with EKG and blood pressure monitoring equipment. Your child’s cardiologist and a technologist monitor your child while she walks/runs on a treadmill. To prepare for the stress test, your child should eat a light meal two hours before coming to the hospital and wear comfortable clothing and athletic shoes. The doctor and technologist will continue to monitor your child for several minutes after the test. Most children feel rested after this brief period. When the test is over, your child can eat, drink and resume normal activities, including returning to school.
Transesophageal Echocardiography (TEE)
This type of echocardiogram is done in a sedated patient by passing a small transducer into the mouth and down the esophagus (the long tube-like structure connecting the mouth to the stomach). The TEE may show the heart and surrounding vessels in greater detail than the traditional surface ECHO. This is also used during most heart surgeries and some interventional catheterizations.
Cardiac Catheterization and Angiography
While the child is asleep under anesthesia, one of our specially-trained cardiologists numbs the skin in your child’s leg and passes catheters, or long, flexible tubes, into the blood vessels and into the heart. These catheters can measure blood pressures and determine any abnormal mixing of blood. Angiograms may also be done. These are injections of contrast, or special dye, to outline the heart structures and help to determine the nature and severity of any heart problem. There are usually two types of cardiac catheterizations:
A heart catheterization is sometimes the most accurate way to evaluate how the heart is functioning. With the information from the catheterization, physical examination, EKG, ECHO and other diagnostic tests, the cardiologist can plan the best care for your child. A catheterization must be done before some types of heart operations to provide information to the heart surgeon. A catheterization is done only if the cardiologist cannot obtain the information he needs from other diagnostic tests. This test is done under general anesthesia, but the child can oftentimes go home that same day.
Using specially-made equipment, the heart catheterization may offer a treatment for your child’s heart problem. In many cases, Interventional catheterization is able to substitute for open heart surgery, but without leaving a scar on the chest. We are able to close holes inside the heart, allow valves to function more normally, close abnormal vessels, and stent open other vessels that are abnormally narrowed. Children who have routine elective interventional catheterization are discharged from the hospital the same day, or the next day following the procedure.