Pediatric cardiology

Definition of pediatric cardiology

Pediatric cardiology is the study of congenital and acquired heart diseases in children. It is a sub-field of pediatric medicine and linked to general cardiology and pediatric heart surgery. Consequently, doctors specializing in diagnostic and invasive pediatric cardiology and pediatric heart surgery work together in close collaboration in clinics. Because of this close collaboration, congenital heart defects in children are detected very early (often while still in the womb) and so can be treated at an early stage. Pediatric cardiology takes a conservative approach to treating congenital heart defects and other heart diseases in children.

Cardiology and pediatric cardiology: different areas of expertise

A doctor may only be called a cardiologist after a successful period of further training. He treats not only heart diseases but also briefs on preventive methods. With regard to congenital cardiac defects and pediatric heart diseases, prevention naturally has no part to play - or at least just a subordinate one. Pediatric cardiologists are responsible for heart diseases in children and usually work in heart centers specializing in the needs of small patients. They do everything to provide the best possible care for children with heart defects. Registered pediatric cardiologists also provide good out-patient care for the children concerned.

What does the term 'pediatric cardiologist' mean?

Pediatric cardiologists have specialized in the particular field of pediatric cardiology. Training for this qualification follows the long period of specialist medical training as a doctor for children and adolescents and lasts another three years. The training involves diagnostic and treatment techniques for heart rhythm disorders, congenital cardiac defects and other conditions of children's hearts. The diagnostic methods used are ultrasound, electrocardiography, magnetic resonance tomography and use of a catheter for heart examinations. Chronic heart rhythm disorders can also be detected by means of special heart catheters.

The commonest diseases treated by pediatric cardiologists are:

• congenital heart defects
• cardiac septum defect
• heart valve constriction
• heart septum defect
• underdevelopment of the left or right cardiac chamber
• reversal of the great cardiac arteries (congenital)
• inflammation of the cardiac muscle
• cardiac arrhythmias (disordered rhythms)

Examination procedure for pediatric cardiologists

The whole examination is entirely pain free. First of all, the doctor examines the rib cage by palpation and listens to the child's heart sounds. He makes an ECG examination and measures the oxygen saturation of the blood. The ECG is standard for every pediatric cardiology examination. This is followed by an ultrasound examination of the heart. This examination lasts between 10 and 15 minutes. Because the child needs to be very still during this, infants are given a bottle to drink. Many doctors also provide films as a form of distraction. Finally, the pediatric cardiologist has a detailed conversation with both parents and child and answers all their questions about further action.

Treatment in pediatric cardiology

A pediatric cardiology clinic provides the most up-to-date diagnostic techniques and treatment options. Heart catheter examinations of infants with congenital heart defects are conducted under operation conditions with a local anesthetic. The therapy depends on the specific diagnosis. This means that congenital malformations are treated differently from acquired heart diseases or heart rhythm disorders. The spectrum is so broad that not everything can be illustrated here. For example, a child may require a heart pacemaker, which is implanted directly underneath the skin. Even fairly big heart interventions are quite usual these days. The treating doctor informs the families concerned individually, stating which special clinic is appropriate for them.

Major advances in pediatric heart surgery

In the field of surgical heart treatment, medicine has made rapid progress in just a few decades. In the 1930s, it was still scarcely possible to adequately treat a diagnosed heart defect, little by little, the initial operation techniques in pediatric heart surgery were developed. Blalock-Taussig anastomosis (connection between two elements that normally diverge and named after the American heart surgeon Blalock and the cardiologist Helen Brooke Taussig) was first performed in 1944 - at the time it caused a sensation. Even today, this method in its modernized form is still used for heart defects of a particular group.

A child's heart defect stresses the whole family

When a heart defect is diagnosed in children, both children and parents experience this as a shock and often feel as if the rug is pulled from under their feet. Both before and after a necessary heart operation, the families concerned are very tense and need psychological support. This is why most pediatric cardiology clinics have psychologists on the staff who support the families as someone to talk to - including long after the intervention itself.