Children's Heart Diagnostic Tests

Finding out what you need to know about your child's heart condition typically involves a variety of tests and diagnostic procedures. At Oklahoma Children’s Hospital Heart Center OU Health, pediatric cardiologists and other children's heart experts use the test results to make the best recommendations for your child's specific situation.

Expert Pediatric Cardiovascular Diagnostic Tests

To help evaluate your child’s condition and develop an accurate diagnosis, your doctor or specialty provider may request one or more commonly ordered diagnostic tests or procedures, including:

• Blood tests and related assessments – Gathers samples of blood, other fluids and body function data such as oxygen saturation to examine cells, minerals, protein, carbon dioxide, oxygen and other indicators of health or illness
• Exercise testing – Checks electrical activity and general function of the heart in response to exercise or stress; also may include pulmonary function tests (spirometry) to assess lung capacity and oxygen levels that support heart function; may combine with echocardiogram for a “stress/echo” to assess blood flow through valves while the heart beats faster during exercise
• Holter/event monitoring – Tracks heart rhythm for short periods (24-48 hours with a Holter monitor) or an extended time (up to a month with an event monitor); helps evaluate chest pain, other heart-related symptoms, irregular beats, abnormal rhythms from a resting EKG and more
• Tilt table procedure – Helps diagnose the source of fainting (syncope), including vasovagal syndrome (sudden drop in blood pressure from nerve dysfunction), arrhythmia or dysrhythmia (heart rates too slow, fast or irregular) or valve disease

Imaging & Radiology Diagnostic Tests

Your child also may need common or specialized cardiovascular imaging studies or minimally invasive diagnostic radiology procedures such as:

• Cardiac catheterization – Helps diagnose and treat congenital heart disease without surgery; performed in the hospital by specially trained pediatric congenital interventional cardiologists; explore cardiac catheterization at Oklahoma Children's Hospital
• Cardiac magnetic resonance imaging (MRI) – Combines a large magnet, radio waves and a computer to create high-resolution still and moving images of major blood vessels and the beating heart; assesses size, structure, function, blood flow and injury to heart muscle; used instead of invasive diagnostic procedures for children and adults with congenital heart disorders or conditions such as tetralogy of Fallot, coarctation of the aorta, hypoplastic left heart syndrome (HLHS), transposition of great arteries, cardiomyopathy, aortic disease, myocarditis and Fontan single ventricle surgery follow-up; learn more about MRI at Oklahoma Children's Hospital
• Chest X-ray – Uses low levels of external radiation to produce images of heart, lungs and/or lung vessels; helps diagnose heart enlargement (congenital defects, cardiomyopathy), pericardial effusion, pleural effusion, pulmonary edema (fluid in lungs), pneumonia and other diseases; compares heart and lung status; helps check position of implanted pacemaker wires or central venous catheters; explore X-ray services at Oklahoma Children's Hospital
• CT scan – Uses specialized X-ray beam that circles the body to capture many detailed views of the same organ/structure; multiple views interpreted by a computer (computed tomography or CT) appear in two dimensions on a monitor; may or may not use contrast dye to highlight organ function during procedure; learn more about CT scans at Oklahoma Children's Hospital
• Echocardiogram – Uses sound waves through a small wand placed on the chest to view moving images of beating heart, walls and valves; also known as echo, cardiac ultrasound or ultrasonography, cardiac Doppler, transthoracic echocardiography (TTE); helps diagnose aneurysm, cardiomyopathy, congenital abnormalities, pericarditis (inflammation), valve disease; explore echocardiography at Oklahoma Children's Hospital
• Electrocardiogram (EKG or ECG) – Measures electrical activity of the heart through leads attached to the chest; helps diagnose enlarged heart, ischemia (decreased blood flow), conduction disorders affecting rhythm (fast, slow, irregular), electrolyte disturbances, pericarditis, valve disease, chest trauma and more; also used to check implanted pacemaker, effectiveness of heart medications, heart condition/status before surgery or during a physical examination or following a heart-related procedure; learn more about electrocardiogram at Oklahoma Children's Hospital
• Fetal echocardiogram – Uses special ultrasound test during pregnancy to assess unborn baby’s heart structure and function; helps determine proper development of all four chambers; allows faster medical/surgical intervention at birth to correct heart abnormalities, if necessary; explore neonatal/perinatal services at Oklahoma Children's Hospital
• Transesophageal echocardiogram (TEE) – Uses small endoscope-like cardiac ultrasound wand carefully guided into the esophagus to evaluate heart structures and blood vessels in the chest; helps assess blood flow in congenital abnormalities, effects of surgical intervention during heart procedures, pulmonary disease if TTE results aren’t clear, tears in lining of aorta; provides better visualization of implanted prosthetic heart valves, mitral valve disease, blood clots or masses inside the heart

Learn more about diagnosing and evaluating heart disease in children. Find out what to expect and how to prepare for your child's Heart Center clinic visit.

Sedation or Anesthesia for Certain Imaging Procedures

Sometimes, one or more tests – CT scans, MRI scans, echocardiogram – can create feelings of anxiety that may or may not disappear as you or your child learn more about what’s involved. If needed, sedatives can help you or your child relax for the test.

Certain diagnostic procedures, such as cardiac catheterization or transesophageal echocardiogram (TEE), are considered minimally invasive and performing them safely and effectively requires sedation or general anesthesia.

At Oklahoma Children's Hospital, you and your child benefit from the expertise of doctors and nurses with advanced training in pediatric anesthesia and sedation who provide the proper amount of medication, as well as the close monitoring and care needed for optimal outcomes.

What to Expect with Sedation or Anesthesia

One of Oklahoma Children’s Hospital’s board-certified pediatric anesthesiologists performs and monitors any needed sedation. They may administer general anesthesia through a breathing mask or IV (intravenously) that allows the person being tested, including adults with special needs or others who can’t lie still, to remain completely asleep during the scan or procedure. The anesthesiologist uses a breathing tube to maintain the person’s breathing throughout the test.

When the exam ends, the anesthesiologist removes the breathing tube. Then, the person tested moves to a special-care area for recovery. With sedation or anesthesia, you or your child may feel groggy, tired or sleepy for several hours after the exam, but these effects usually disappear within a day or so.

Your Child’s Heart Care Team

During the time you and your child spend at the Oklahoma Children’s Hospital Heart Center, you’ll work with a variety of talented, compassionate and highly trained experts – doctors, nurses and staff who provide specialized pediatric services to diagnose and treat your child’s specific condition.

Your child’s heart and vascular care team may include pediatric cardiologists, pediatric cardiothoracic surgeons, pediatric cardiac anesthesiologists, pediatric critical care specialists and pediatric cardiac nurses, as well as child life specialists, social workers, therapists and healthcare professionals from many disciplines.

You benefit from working with an experienced pediatric cardiovascular team that directly involves you and your family in treatment decisions, also pays close attention to your family’s nonmedical needs and:

• Performs more than 500 complex cardiothoracic surgeries each year
• Uses the latest advanced technologies, including minimally invasive procedures that help speed healing and recovery
• Brings together specialists from all departments to coordinate and implement new and innovative treatments for children’s heart and vascular conditions
• Cares for the tiniest hearts through our extracorporeal membrane oxygenation (ECMO) program, a nationally designated ECMO Center of Excellence
• Conducts groundbreaking research on hypoplastic left heart syndrome (HLHS) with nationally renowned colleagues from across the United States and brings new methods for prevention, diagnosis and treatment to your care through participation in locally available clinical trials
• Teaches the physicians of tomorrow for the University of Oklahoma College of Medicine, which also gives you access to benchmark practice standards, innovative care and treatment methods, advanced technology and world-class research
• Puts smiles on the faces of children and families during more than 10,000 outpatient visits each year