Angie's LIST Guide to
Pediatric cardiology

Pediatric cardiologists care for children and young adults with heart disease as well as congenital heart defects in adults. These specialists also help when there is a problem with the fetus's heart before birth.


Photo collage of babies and doctors.
Children often are diagnosed with illnesses and conditions that affect adults, but because of their special needs, they are often referred to pediatric specialists. Specialists in all areas can provide treatment plans to improve health and quality of life.

What pediatric cardiologists do

A pediatric cardiologist diagnoses and treats systemic disorders affecting a child's cardiovascular system, including congenital heart defect, heart muscle disorder, rhythm disturbances and hypertension. These physicians also care for patients who no longer fall into the pediatric age range when an underlying congenital heart defect or other condition requires specialized treatment such as long QT syndrome, a disorder affecting the electrical system of the heart.

Congenital heart disease refers to a condition that has been present since birth. Congenital heart defects can involve malformations of the heart or large blood vessels near the heart. Some of these defects are found at birth or before, whereas others show up as a child grows up. Some people don't have a detectable problem until adulthood. About one in every 100 babies is born with congenital heart disease, and medical researchers have identified at least 35 different types of congenital heart defects.

A cardiac specialist is also called in when a suspected heart condition occurs in an unborn child. Monitoring the fetus through fetal echocardiography helps doctors decide whether immediate intervention is required. This specialist can help guide the situation while the infant is in the womb and prepare for treatment after birth.

Children may also be exposed to conditions that can cause acquired heart disease. Most common cases involve mucocutaneous lymph node syndrome (or Kawasaki syndrome, which affects the mucous membranes and glands), hypertension, endocarditis (inflammation of the heart lining) or heart injury due to infections or viruses.

Training for a pediatric cardiologist

After studying general medicine, pediatric cardiologists specialize in either pediatrics or a mixture of internal medicine and pediatrics during their residency. Following this, a doctor continues on to a three-year program to specialize in pediatric cardiology.

This branch of medicine involves diagnosis and treatment of heart disorders, but does not include performing surgeries. Pediatric cardiothoracic surgeons or pediatric heart surgeons perform these procedures when necessary.

Pediatric cardiologists are board certified in their primary specialty and certified in their subspecialty. These well-trained doctors can give expert advice on procedures required immediately as well as give advice about preventing heart attacks and other potential heart and general health problems as a child's cardiac care proceeds.

If you know that you'll need the services of a pediatric cardiologist, contact your health insurance company to make sure that this medical specialty is covered. Depending on your policy, you may need a referral from your primary care physician in order for your policy to pay for treatment. Read through the listing of pediatric cardiologists in the provider directory available from your health insurance company. Verify their qualifications, education, continuing education, accepted insurance plans and affiliated hospitals by consulting Angie's List, where you can also see member reviews and rankings. 

Cardiac diagnostic tools

If your primary care physician notices something unusual during a checkup, he or she may provide a referral to the pediatric cardiology department at a local hospital. A specialist might be called in to evaluate heart murmurs, rapid breathing, chest pain, fainting episodes or certain infections. An obstetrician may refer a pregnant patient if a congenital defect is suspected as early as 18 weeks of gestation.

All patients receive a thorough examination when under the care of a pediatric cardiologist. In most cases, evaluation alone can find the problem using noninvasive and minimally invasive tests. Noninvasive tests are conducted without needles or inserting instruments or fluids in the body. Minimally invasive tests on the other hand can include a needle prick for a blood test, shot or insertion of a tube (catheter) or other device.

Specialized tests such as electrocardiogram and echocardiogram may be required. There could also be a reason to order exercise stress testing, which involves placing a monitor with electrodes on the skin to record the heart's activity.

When dealing with pregnant women, the specialist will use fetal echocardiography, which is much like ultrasound but focused on the heart structure of a fetus.

Two effective tests, cardiac MRI and cardiac CT scans, are important tools in cardiology. Cardiac MRI involves magnetic resonance imaging to create two-dimensional and three-dimensional images of the heart and vessels while cardiac CT scans uses short bursts of X-rays to create images of the heart and vessels.

Cardiac catheterization is a minimally invasive diagnostic test that examines the inside of the heart's blood vessels by injecting contrast via microtools.

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