These are some of the noninvasive and minimally invasive tests and procedures performed by the cardiology team at St. Louis Children's Hospital:
Gives the cardiologist a picture of the size and shape of your child's heart and indicates the presence or absence of fluid in the lungs. Different views are common, and may include the front and side of the child, standing or lying down.
Measures electrical activity in the heart, the heart's rate and rhythm, any damage to the heart muscle and any unusual events in the conduction system. The test takes about 15 minutes and requires only that several wired patches be placed on the chest, arms and legs.
Enables the cardiologist to see details of the heart structure from outside the body and helps determine the need for further evaluation or treatment.
The test lasts about 30 to 45 minutes. During the test, all the child will feel is the transducer touching his or her chest. A transducer is a flat-bottomed instrument, about six-inches long, that moves smoothly along the chest. A clear gel will be applied to the chest to help the transducer move smoothly.
Sedation is sometime necessary to ensure good pictures. Your child may be given something to drink that will help him or her go into a light sleep.
A Holter monitor measures heart rate and rhythm for a 12- to 24-hour period. It is commonly worn by a patient before and after cardiac surgery, so the doctor can compare before and after information on the heart's electrical activity.
A Holter monitor is a box carried on a shoulder strap with wires that are painlessly connected to the chest with patches. The patient's nurse or family keeps a diary of the child's activities, such as walking, eating and crying, and the time they occur. The doctor uses this information to see how the activities affect heart rate and rhythms.
Cardiac catheterization is a procedure performed by inserting a long, thin tube - a catheter - into an artery and vein and advancing it to the heart. The doctor can see the movement and location of the catheter through X-rays that are displayed on a television screen.
Dye that shows up on an X-ray is injected into the heart through the catheter. This process is called angiography. As the dye flows through the heart, it allows the cardiologist to see and take pictures of the heart's chambers, valves and blood vessels. The cardiologist also can measure blood pressure variances in each chamber.
Interventional procedures are done in the cardiac catheterization lab. These include ballooning a small valve or vessel, and embolizing a vessel using a coil, and closing holes in the heart among others. Many interventional procedures are alternatives to surgery.
Click here to open a video about cardiac catheterization [WMV | QT]
Dr. David Balzer, Cardiologist
The day before the cardiac catheterization, your child will receive precatheterization testing, which includes cardiac tests and chest X-rays. This testing begins at St. Louis Children's Hospital's Outpatient Testing Area. A Cardiologist will meet with you to review your child's medical history, explain the cardiac catheterization procedure, and obtain a signed consent form. You also will be told when your child should not have anything more to eat or drink. On the morning of the cardiac catheterization, you should go to the Admitting Desk at your scheduled time.
When your child is called for the cardiac catheterization, the nurse will ask him or her to use the bathroom. One hour prior to the procedure, a premedication cream will be placed on both groin areas to numb the areas. The child also may be given a premedication to drink that makes him or her drowsy.
You may stay with and hold your child until he or she is ready to enter the cardiac catheterization lab. At that time, you will be asked to return to your child's room. The procedure lasts approximately three hours. If you leave your child's room, let the nurse know where you will be.
As soon as the procedure is completed, your child returns to his or her room, and a cardiologist will discuss the preliminary findings with you. A thick pressure dressing of elastic tape and gauze sponges will cover the catheter site.
Your child may be sleepy for a while from the sedative used during the procedure. To help prevent bleeding, the child should lay flat for several hours. Your child may receive fluids when he or she awakes, and diet will be advanced slowly as tolerated.
If surgery is not planned for the following day, your child will be discharged the morning after the catheterization. On certain occasions, your child may be able to go home the evening of the cardiac catheterization. Before discharge, a cardiologist sees your child and determines whether it is appropriate to leave. You will receive discharge instructions and supplies needed for wound care.
Measures the heart's electrical system to help assess arrhythmias, which are abnormal heart rhythms.
An EPS is similar to a cardiac catheterization. It is performed by inserting catheters into veins and advancing these into the heart. The movement and location of the catheter are shown to the doctor by X-rays displayed on a television screen. Electrical wires with sensors on the ends are passed through veins to certain areas of the heart.
Provides a detailed view of the heart. The MRI equipment creates a large magnetic field that causes atoms in the body's tissue to emit radio waves that are received by an antenna. A computer converts the signals into visible images of the heart and arteries.
During this test, your child will lie on a sliding table that goes inside a large tube. Except for EKG leads attached to the child's chest with adhesive, nothing touches the child, and the child will not feel any sensations. The exam lasts about one hour.
Cryoabalation or CryoTherapy is a minimally invasive procedure that treats certain arrhythmias by using a freezing technique to restore normal electrical conduction to heart pathways, in order to regain control of the heart’s rhythm. Because of the way this technology freezes cells rather than cauterizing them with heat as in the conventional RF treatment, it may offer a safer and more effective option when treating certain arrhythmias and working with heart tissue.