Echocardiogram - Children

An echocardiogram is a test that uses sound waves to create pictures of the heart. It is used with children to help diagnose defects of the heart that are present at birth (congenital). The picture is more detailed than a regular x-ray image. An echocardiogram also does not expose children to radiation.

How the Test is Performed

Your child's health care provider may do the test in a clinic, in a hospital, or at an outpatient center. Echocardiography in children is done either with the child lying down or lying in their parent's lap. This approach can help comfort them and keep them still.

For each of these tests, a trained sonographer performs the test. A cardiologist interprets the results.

Transthoracic Echocardiogram (TTE)

TTE is the type of echocardiogram that most children will have.

• The sonographer puts gel on the child's ribs near the breastbone in the area around the heart. A hand-held instrument, called a transducer, is pressed on the gel on the child's chest and directed toward the heart. This device releases high-frequency sound waves.
• The transducer picks up the echo of sound waves coming back from the heart and blood vessels.
• The echocardiography machine converts these impulses into moving pictures of the heart. Still pictures are also taken.
• Pictures can be two-dimensional or three-dimensional.
• The entire procedure lasts for about 20 to 40 minutes.

The test allows the provider to see the heart beating. It also shows the heart valves and other structures.

Sometimes, the lungs, ribs, or body tissues may prevent the sound waves from producing a clear picture of the heart. In this case, the sonographer may inject a small amount of liquid (contrast dye) through an IV to better see the inside of the heart.

Transesophageal Edhocardiogram (TEE)

TEE is another type of echocardiogram that children can have. The test is done with the child lying under sedation.

• The sonographer will numb the back of your child's throat and insert a small tube into the child's food pipe (esophagus). The end of the tube contains a device to send out sound waves.
• The sound waves reflect off the structures in the heart and are displayed on a screen as images of the heart and blood vessels.
• Because the esophagus is right behind the heart, this method is used to get clearer pictures of the heart.

Why the Test is Performed

This test is done to examine the function, heart valves, major blood vessels, and chambers of a child's heart from outside of the body.

• Your child may have signs or symptoms of heart problems.
• These may include shortness of breath, poor growth, leg swelling, heart murmur, bluish color around the lips when crying, chest pains, unexplained fever, or germs growing in a blood culture test.

Your child may have an increased risk for heart problems due to an abnormal genetic test or other birth defects that are present.

The provider may recommend a TEE if:

• The TTE is unclear. Unclear results may be due to the shape of the child's chest, lung disease, or excess body fat.
• An area of the heart needs to be looked at in more detail.