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Echocardiogram

Echocardiogram in Children

An echocardiogram ("echo") is an ultrasound test that uses sound waves to view the heart. It is safe, painless, and without radiation. Pictures of the child's heart can be viewed on a small monitor while the procedure is being performed. 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.

Description of an Echocardiogram

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 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 uses sound waves, which bounce off the different parts of a child's heart, creating a picture.

The transducer is moved over the chest, abdominal area, and neck in order to obtain the images.

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 moves through the heart.

The colors you see on the screen are not the colors of the blood. 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. A child may feel some discomfort from the pressure of the transducer. 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 appear on the screen. This image is recorded into a digital storage system for the cardiologist to measure and review. 

Echocardiogram Uses

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 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 backward flow.

Preparing Your Child

If a child is 4 years old or less, he / she may require sedation for the echocardiogram. Mild sleeping medications are used. These medications will be administered by mouth or squirted in the nose (like saline spray).

Children older than 4 years of age generally do not require sedation for their echocardiograms. However, if an older child needs sedation, they may be scheduled for a sedated echocardiogram.

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

  1. No milk or solids for eight hours before the scheduled procedure.
  2. Breastmilk can be given up to four hours before the scheduled procedure.
  3. Clears liquids (such as clear juices, pedialyte or water) may be given up to two hours before the procedure.

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

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

Questions & Answers

Who performs the test?

A registered sonographer trained in echocardiography will typically perform the echo. 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, they will need to stay until the nurse or doctor feels they are ready to leave the hospital – usually about 20 to 30 minutes after they wake up.

How do I learn about the test results?

Your cardiologist can review the results of the echocardiogram immediately, and the results are often communicated before you leave.

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

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Contact Cincinnati Children's Heart Institute

Last Updated 06/2020

Reviewed By Beth Shaw, RNII

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