Echocardiogram in Children

An echocardiogram ("echo") is an ultrasound test that uses high frequency sound waves (non-radioactive) for viewing the heart. It is a safe and painless procedure that helps doctors diagnose heart problems.

Pictures of the child's heart can be viewed on a small monitor while the procedure is being performed. It is a non-invasive test (no probes or needles) and everything is done from the outside of the body.

An echocardiogram is similar to a sonogram many women have had before a child was born; however, the echocardiogram focuses specifically on the heart and blood vessels around the heart.

The child will lie down tilted slightly on his / her side on a hospital bed in our child-friendly examination room, not an operating room. Many exam rooms are equipped with a television and DVD players to keep a child entertained and alleviate boredom. The child must be undressed from the waist up and can choose to wear a short gown.

To improve the quality of the pictures, a colorless, warm gel is applied to the skin on the area of the chest where the heart is located. A transducer, a small microphone-like device, is placed on top of the gel and against the skin. The transducer is able to send sound waves into the chest, which bounce off the different parts of a child's heart creating a picture.

The transducer will be moved over the chest, abdominal area, and neck in order to obtain the images of the heart and surrounding blood vessels.

The sounds you may hear from the echo machine are the sounds of the blood flowing from one chamber to another and the valves opening or closing as the blood goes through.

The colors you see on the screen are not the colors of the blood in the heart. The colors tell us what direction the blood is flowing. The red color shows the blood is flowing towards the transducer and the blue color shows blood is flowing away from the transducer. A child may feel some discomfort from the pressure of the transducer; however, this varies from child to child. Pediatric echosonographers are trained to complete scans in as pain-free and patient-sensitive manner as possible.

A computer interprets the information from the transducer to make an image of the heart. This image is displayed on a small TV screen on the echocardiogram machine and is recorded into a digital storage system for the cardiologist to measure and review. 

Echocardiograms are generally the best tests to demonstrate the structure and function of the components of the heart. The echocardiogram is used for measuring the size and thickness of the heart chambers, how the heart is handling the pumping of blood through the chambers, and blood flow through the heart valves.

The echocardiogram can detect structural abnormalities of the heart (holes between the chambers, fluid around the heart, mass inside the heart, etc.) and show valve shape, motion, narrowing or leaking.

If a child is 4 years old or less, he / she may require sedation for the echocardiogram. A mild sleeping medication is used that is usually taken by mouth.

Before a child can be sedated he must have an empty stomach. These guidelines should be followed:

  • Infants 0 to 5 months: No milk or solids for four hours before the scheduled procedure
  • Infants 6 to 36 months: No milk or solids for six hours before scheduled procedure
  • Patients older than 36 months: No milk or solids for eight hours before scheduled procedure

Clear liquids (apple juice, Kool-Aid, breast milk, 7-UP, cranberry juice, etc.) can be taken up to two hours before the test for all children being sedated.

If a child is to be sedated, we ask that every effort be made to keep the child awake until after she has had sedation. Postponing the nap will help a child fall asleep faster with the sedation.

Children older than 4 years generally do not require sedation in the echocardiology laboratory. If an older child needs sedation, the test may need to be performed in an operating room setting with anesthesia support.

If children are not sedated, they may eat and go about their normal activities immediately following the study, unless you are told otherwise.

Who performs the test?

A registered sonographer trained in echocardiography will typically perform the echo. If the sonographer is not registered, a physician will assist and monitor the echocardiogram.

Occasionally, a physician may perform the entire echo. Sometimes, a cardiologist specialized in echocardiography will come in at the end of the study, review images or may obtain additional images.

Who interprets the test?

A cardiologist who specializes in echocardiography will review the study and generate a report.

How long does an echocardiogram take?

The echocardiogram usually takes between 30 minutes to an hour in an unsedated but cooperative child. If a child is sedated for the study, he or she will need to stay until the nurse or doctor feels the child is ready to leave the hospital.

How do I learn about the test results?

If you are having a visit with your cardiologist after the echocardiogram, the results may be available before you leave.

Results of a child's echocardiogram can be obtained from the ordering physician within 24 hours from the test.

Last Updated 12/2013