Annex A > Chapter 3 - Developments in the UK, in the Diagnosis and Treatment of Congenital Heart Abnormalities in Children, 1984-1995 > Diagnosis and initial assessment

Diagnosis and initial assessment

12 A serious congenital heart abnormality will usually be recognised or suspected within a few days after birth, often while the baby is still in the newborn unit of the hospital. In that case the paediatrician will ordinarily make early contact with a paediatric cardiologist.

13 In some babies there may be no obvious symptoms and signs for several days or weeks. In those cases, the parents, the midwife, health visitor or general practitioner will be involved in recognising a problem. Referral to a paediatrician usually follows. If a heart abnormality is judged to be likely, the paediatrician will also decide how urgently a paediatric cardiologist should be consulted.

14 The paediatric cardiologist is responsible for the initial assessment and diagnosis of a congenital heart abnormality. When necessary, he initiates emergency medical treatment and at an early stage involves a surgeon in planning the timing and strategy of management. Perhaps the cardiologist's most important function is the identification and diagnosis of heart abnormalities and heart disease. The decision to proceed with cardiac surgery is a decision made between the family, the cardiologist and the cardiac surgeon, and of course the patient, to the level of his understanding.

15 If it is thought that surgery may be required, the cardiologist is expected to provide a clear picture of the cardiac abnormality. In order to make a diagnosis, the paediatric cardiologist will use various technologies which have advanced significantly during the past 20 years. They are principally: (1) the use of ultrasound scanning which is non-invasive (known as echocardiography), and (2) cardiac catheterisation which is invasive and consequently involves some risk to the patient. [5]

<< previous | next >> | back to top

Footnotes

[5] Ultrasound scanning is a procedure in which some jelly is placed on the chest and a small pencil-like probe is held lightly on the skin. A cardiac catheterisation is invasive in the sense that the skin is punctured with a needle which is then guided into a blood vessel. A thin tube (or catheter) is then guided by various manoeuvres into the blood vessel and is advanced along the larger blood vessels into the heart