Non-invasive testing and advanced cardiac imaging to help diagnose your child’s heart problem
Did you know that congenital heart disease affects 1% of all births in the United States per year? Heart disease is also the leading cause of infant deaths associated with birth-defects. With advancements in care and access to state-of-the-art technology, there are now more adults living with congenital heart disease than children.
At CHoR, we have access to the latest technology to assist in both diagnosis and treatment, an important part of our mission to focus on non-invasive testing and cardiac imaging approaches. Our faculty and technologists make it a priority to stay ahead of technologies and continued education, as our field continues to advance at a neck-breaking speed.
Pediatric non-invasive testing and cardiac imaging services offered at our clinics
Echocardiograms
Using ultrasound, we are able to visualize the structures of your heart and blood vessels as they move with each heartbeat. Our pediatric echocardiography lab is the only lab in Central Virginia accredited by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories for transthoracic and transesophageal studies in children, as well as fetal echo studies.
We have this technology readily available at the main campus and at all outreach clinics. We do our best to work with patient and families to ensure high quality images, including swaddling babies and having movie watching capabilities.
An echocardiogram can:
- Show how thick the heart is.
- Show how well the heart is contracting.
- Presence of congenital heart disease, such as a hole in the walls of the heart.
- Show a normal heart in the setting of an innocent murmur.
Fetal echocardiograms
We are able to look at your fetus’s heart as early as the second trimester and help guide you through the next phases. Early recognition of heart problems will help with genetic counseling, delivery planning, and surgery, if necessary.
Cardiac MRI
Magnetic resonance imaging is a powerful way to see details of the heart without any exposure to radiation. We have a dedicated team of physicians and technologists who specialize in this, as well as six scanners throughout the campus that can accommodate imaging in children as young as newborns, to adults with congenital heart disease.
MRIs:
- Measure how well the heart is contracting.
- Measure the size of the heart.
- Look for evidence of swelling or scarring of the heart.
- Show abnormal heart or blood vessel structures.
- Measure how much a valve in the heart is leaking.
- Look for tears in the blood vessel.
- Look for infection or deposition in the heart muscles.
Cardiac MRIs are performed at the Children's Pavilion where a physician is readily available to scan with the technologists. Children older than 7 years and who can follow instructions can be scanned without sedation. We will need the help of the children to hold their breaths for short periods to acquire high quality images.
MRI-based approaches are the longest of the 3 non-invasive imaging approaches, but is an important option when echocardiographic images are not adequate. This is especially true in older children and adults with congenital heart disease, where it is difficult to see the heart using an echocardiogram. One of the most important factors to consider is that a MRI does not expose a child to radiation.
Cardiac Computed Tomography (CT)
CT allows physicians to see even the smallest vessels in your heart. Our pediatric-dedicated team is knowledgeable in minimizing radiation dose and understanding congenital and acquired pediatric heart disease.
CT's will:
- Look at the coronary arteries, which provide blood to the heart muscles.
- Look at abnormal connections of the blood vessels.
- Measure how well the heart is contracting.
- Show abnormal heart or blood vessel structures.
- Look for tears in the blood vessel.
Cardiac CTs are also performed only at the Children's Pavilion. We work with our expert radiologists to ensure we minimize exposure to radiation and can safely get the pictures in only minutes. This is especially important if you have small infants!
Electrocardiography (EKG) monitoring
This non-invasive heart test records the electrical activity of your child’s heart through a graph. This test gives our heart care specialists information about the rhythm of the heart to see if it’s too fast, too slow or irregular.
Exercise stress testing (including metabolic stress testing)
By using exercise, our pediatric cardiologists can monitor your child’s heart rate, breathing, blood pressure, EKG and how tired they feel during peak exercise. We use conventional approaches like echocardiography to see your heart work at rest compared to exercise. In addition, we are one of the few centers in the world who also specialize in the use of MRI to evaluate your heart during exercise.
Heart monitoring tools
Through devices such as pacemakers, Holter monitors and more we can help test your child’s heart rhythm for any irregularities. Some of our patients will be set up with these monitoring tools in our clinics and continue to be monitored at home.
Signs your child may need cardiac testing:
- If your newborn has low oxygen saturation.
- Your pediatrician hears a heart murmur or has concerns about his/her heart.
- Your child has high blood pressure.
- Your child is falling off the growth curve.
- Your child has a hard time keeping up with other kids when they are running or playing hard.
- Your child’s lips look blue or purple.
- Your child has chest pains or palpitations, especially during exercise.
- Your child fainted during exercise.
- Your family has a history of heart disease in children or young adults.
What is a normal heart rate for children and when should a parent be concerned?
Your child's heart rate will vary depending on their age and activity. At rest, the heart rate will be lower than if they were running, for example. According to the American Heart Association, the following are normal ranges for children at rest:
- Newborns to 3 months of age range from 85 to 200 beats per minute , with an average heartbeat of 140 beats per minute.
- 3 months to 2 year olds range from 100 to 190 beats per minute
- 2 to 10 year olds range from 60 to 140 beats per minute
- Older than 10 years of age range from 60 to 100 beats per minute
Telemedicine appointments allow us to work with you to care for your child’s heart at home
Our children’s heart center provides cardiac monitoring services and interpretation via telemedicine appointments.
For example, we can monitor your child’s EKG outside the hospital using transtelephonic EKG monitoring (a monitor your child will where for 30 days to track their heart’s rhythm), Holter monitors (another small, wearable device that will allow us to keep track of your child’s heart rhythm), event recorder tests (a battery powered device you can control to tape record your child’s EKG), pacemakers or defibrillators.
Services are provided to community hospitals in Richmond, Newport News and Fredericksburg.
LEARN MORE ABOUT OUR TELEHEALTH SERVICES