Pediatric Cardiologists and Information on Pediatric Cardiology

The most common congenital malformation in children affects the heart. About one in every 100 children has a heart defect.

Heart diseases in children differ significantly from the heart diseases in adults, which are mostly acquired. Therefore, children need specialized medical care from trained pediatric cardiologists. These specialists work closely with pediatric cardiac surgeons. Fortunately, treatment options are very good today.

Congenital heart defects are the most common congenital malformation. @ ShunTerra /AdobeStock

Only after successfully completing specialized training may a physician call themselves a cardiologist. They not only treat heart diseases but also educate patients about prevention options.

In the case of congenital heart defects and pediatric heart diseases, prevention plays no role or only a minor one.

Pediatric cardiologists specialize in heart diseases in children. They typically work in cardiac centers that specialize in the needs of young patients.

They do everything they can to ensure that children with heart defects receive the best possible care. Private-practice pediatric cardiologists also provide excellent outpatient care for affected children.

Pediatric cardiology is a distinct subspecialty of pediatrics @ Peakstock /AdobeStock

Pediatric cardiologists have specialized in pediatric cardiology. This advanced training lasts three years and follows the five-year residency to become a board-certified pediatrician.

The training focuses on diagnostic and treatment methods for cardiac arrhythmias, congenital heart defects, and other childhood heart conditions.

The most common conditions treated by a pediatric cardiologist are congenital heart defects such as:

• Ventricular septal defect (VSD): a hole between the two ventricles
• Atrial septal defect (ASD): a hole between the two atria
• Pulmonary stenosis (narrowing of the pulmonary valve): Narrowing of the right heart valve
• Patent ductus arteriosus (persistent ductus arteriosus): an unclosed connection between the pulmonary artery and the aorta
• Transposition of the great arteries
• Underdevelopment of the left or right ventricle
• Inflammation of the heart muscle (myocarditis)
• Heart rhythm disorders

Ventricular septal defect is by far the most common heart defect: it accounts for about 50 percent of congenital heart and vascular abnormalities. Approximately 5 out of every 1,000 newborns are born with this heart defect.

The entire examination is painless. During a detailed consultation, the doctor answers all questions regarding the diagnosis and the planned course of treatment.

During the patient interview (medical history), the doctor will ask the child or the parents questions about:

• Symptoms
• Symptoms
• Pregnancy history and
• Previous findings

During the physical examination, the pediatric cardiologist looks for general signs of a heart defect as well as other physical abnormalities.

These include:

• Blue discoloration of the skin (cyanosis)
• Failure to thrive
• Excessive sweating
• Difficulty feeding
• Rapid breathing or other respiratory abnormalities as signs of heart failure (cardiac insufficiency)
• Bulging of the abdomen or chest
• Changes in the veins

It is particularly important to auscultate the child’s heart sounds. Palpating the pulse, measuring blood pressure, and determining blood oxygen saturation also provide clues to heart disease. An ECG is standard for every pediatric cardiology examination.

During a physical stress test (ergometry), the doctor assesses the child’s physical performance under stress.

Through an ultrasound examination of the heart, the doctor evaluates the heart, blood vessels, and blood flow. In most cases, the examination is performed externally through the chest.

This test is simple to perform and takes between 10 and 15 minutes. Since the child must remain very still during the procedure, infants are given a bottle to drink from.

Many doctors also offer videos to keep the child distracted. In some cases, doctors must insert the ultrasound probe into the esophagus under sedation or anesthesia.

The ultrasound exam is not painful, and children do not need to fast beforehand @ megaflopp /AdobeStock

Depending on the suspected diagnosis, further tests may be necessary, such as an electrophysiological study if cardiac arrhythmias are suspected.

If a cardiac catheterization is necessary for an infant with a congenital heart defect, it is performed under surgical conditions and general anesthesia. Therapeutic procedures can also be performed using a cardiac catheter.

Other imaging procedures used to address specific clinical questions include:

• X-rays
• Magnetic resonance imaging (MRI) and
• Computed tomography (CT)

A pediatric cardiology clinic offers state-of-the-art diagnostic and treatment options.

Treatment depends on the diagnosis. For example, congenital heart defects require a different treatment approach than acquired heart diseases or arrhythmias.

The range of treatments is diverse. For example, a child may need a pacemaker, which doctors implant directly under the skin.

Even major heart surgeries are routine procedures today. The attending physician will advise affected families on a case-by-case basis as to which specialized clinic is appropriate for them.

In the field of surgical cardiac therapy, medicine has made rapid progress in just a few decades. The origins of cardiac surgery date back to 1896, when doctors sutured a 22-year-old patient with a stab wound to the heart.

However, in the 1930s, it was still virtually impossible to adequately treat a diagnosed heart defect. Gradually, the first surgical methods in pediatric heart surgery were developed.

The Blalock-Taussig shunt (named after the American cardiac surgeon Blalock and the cardiologist Helen Brooke Taussig) was first performed in 1944. This was a sensation at the time.

An artificial vascular connection made it possible to improve pulmonary blood flow. For the first time, the so-called “blue babies” had a chance of survival. Even today, this method is still used in a modernized form for certain heart defects.

Children and their parents are shocked by a diagnosis of a heart defect. Even before and after heart surgery, the affected families are under a great deal of stress and need psychological support.

That is why most pediatric cardiology clinics employ psychologists who serve as points of contact for the families—even after the procedure.