Fetal Echocardiography: Purpose, Procedure and Risks

Fetal Echocardiography is a non-invasive that uses sound waves to assess the condition of the heart of an unborn and developing baby. The test is very similar to an ultrasound and helps in better evaluation of the structure and functioning of the heart of an unborn child. The test is usually performed on women who are in their second trimester (in 18 to 24 weeks) of pregnancy. However, it can also be done during the later stages of pregnancy, if the need arises. Fetal echocardiography is also used to check for any heart defects in the child before birth. 

In fetal echocardiography (echo) the sound waves echo back from the structure of the baby’s heart, which are then analysed by the help of a machine that converts these sound waves into images of the heart’s internal structure. This helps in a detailed analysis of the baby’s heart, its health, functioning, blood flow and also checks for any deformities or abnormalities in the heartbeat or rhythm. The test is safe and painless and is performed to minimize risks of heart defects at birth.

Purpose of Fetal Echocardiography

Fetal echocardiography is not compulsory and is recommended to pregnant women in whom a basic ultrasound might not have been able to deliver conclusive results of the child’s heart. It can also be recommended in cases, where an abnormality or an abnormal heartbeat is detected in the foetus. 

Cases where fetal echocardiography is highly recommended include, but are not limited to:

  • Women who have a family history of heart diseases
  • Women whose first child has a heart condition
  • Women who consume alcohol or drugs during pregnancy
  • Women who have taken or have been exposed to medications and drugs that can cause heart abnormalities
  • Women who have medical health conditions involving diabetes of type 1, rubella, etc.
  • Women who have certain infection during pregnancy
  • Women have abnormal test results 
  • Women who conceive using assisted reproductive technology
  • Foetus diagnosed with a genetic problem
  • Abnormalities in ultrasound
  • Women who become pregnant at an advanced stage

Procedure of Fetal Echocardiography

The test is non-invasive, safe and usually takes about 30 minutes to be performed. There are no preparations that need to be done before the test and is very similar to a routine pregnancy ultrasound. Fetal echocardiography is done through the abdomen or the vagina; if done through the former, it is called abdominal echocardiography, while the latter is called transvaginal echocardiography.

In abdominal echocardiography, you will be required to lie down. Then a special lubricating gel will be applied on the bare belly which will enable the technician to use an ultrasound transducer to send and receive signals from the sound waves over the skin. The transducers sends sound waves through the body, which eco upon hitting the child’s heart are reflected back to the transducer and are then converted into images on a screen. The transducer is moved all over the stomach to get complete images of the heart. 

In case of transvaginal echocardiography, a small probe is inserted into the vagina which sends sound waves to provide images of the baby’s heart. This method is usually sued during the early stages of pregnancy and also provided better images than abdominal echocardiography.

Post both procedures, the gel or the probe, are removed from the body, and the patient can return to a normal routine within no time. The procedure is highly safe since it uses ultrasound technology and not radiation.

The results of the test will be explained by the doctor and treatment or precautions, if any, will also be suggested. There might be a need for another echocardiography if any abnormalities are detected in the first test. In many cases, if the results of the echocardiography are non-conclusive, the doctor might suggest more tests such as MRI scan or other high-level ultrasounds to properly diagnose the condition. However, it is critical to note that a fetal echocardiogram may not be able to diagnose all health conditions; some issues such as a hole in the heart are difficult to diagnose even with advanced procedures.

Risks of Fetal Echocardiography

Fetal echocardiography is a non-invasive and safe procedure that uses high-frequency sound waves to create images of the baby’s heart. The test does not use radiation which makes it even safer. The procedure has not reported any negative effects on the development of the child and hence, does not have significant risks involved. 

Fetal echocardiography is an easy and safe test which is recommended for pregnant women in their third trimester to check for the health and functioning of the baby’s heart. The test is helpful in diagnosing issues and enabling treatment to treat the condition, if any, early on. 

How pediatric cardiac surgery is different from adult cardiac surgery?

Today, in India, the rate of heart problems among children under 18 years of age, are not very common but are steeply rising. This is alarming and needs to be dedicated, world-class care. These problems could be due to multiple reasons such as genetics, birth defects, unhealthy lifestyle, improper growth, smoking and alcohol consumption during pregnancy by the mother or more. Mostly, heart problems in children develop while they are in the uterus and other cases could also be caused by certain illness during childhood. Cardiac ailments in children can take several forms and need expert medical attention – medications, surgery, post-follow-ups, etc. Paediatric cardiologyis the field which is dedicated to providing holistic treatment for children of all ages; it encompasses comprehensive care for patients – from pregnancy, through infancy, childhood, teenage years and later – that have congenital or acquired heart problem.

Children are very different from adults and one such area of the vast difference in the cardiac space. The cardiac problems of children vary immensely than those of normal adults; hence, children their care needs to be more specialized and attentive. Many children suffering from heart problems do not show any symptoms and may appear healthy, hence, oftentimes such problems also tend to get ignored until later when they become extremely critical. Paediatric cardiology is a branch of general cardiology that exclusively focuses on children, infants and unborn children with various cardiac problems, and involves diagnosis, prevention and treatment of cardiac defects and problems in them. 

One should visit a paediatric cardiologist if the child tends to show any of the below symptoms such as: 

  • Blue lips and skin
  • Difficulty in feeding (sweating, breathlessness, etc.)
  • Shortness of breath
  • Palpitations
  • Poor growth
  • Pale skin
  • Fatigue
  • Weak immunity
  • Heart murmur
  • Fainting
  • Lack of physical activeness
  • Chest pain

The symptoms indicate that the heart is not functioning properly and needs medical attention. That said, paediatric cardiologists are doctors who have expertise in diagnosing and treating children with heart conditions. These paediatric cardiologists’ work closely with cardiothoracic surgeons, paediatricians focussed on other specialities, and expert nurses and staff to provide high quality, patient-centric and family-oriented care for children. A paediatric cardiologist can treat several conditions for patients such as:

  • Infancy cardiovascular collapse
  • Cardiac failure
  • Newborn cyanosis
  • Heart murmurs
  • Chest pain, palpitations
  • Fatigue and fainting
  • Congenital heart problem
  • Cardiovascular defects
  • Cardiac abnormalities
  • Heart transplant
  • Aortic valve stenosis
  • Arterial trunk
  • Atrial septal defect (ASD)

Paediatric cardiology entails learning general paediatrics to ensure all-round care of the growing and developing individual. It involves the treatment of congenital heart defects, irregular heartbeat and rhythm, as well as circulatory function problems. Additionally, Paediatric cardiology involves extensive training and skill in handling and treating children, in the best possible manner. 

Paediatric cardiology also involves performing several tests to detect heart problems. These tests are simple, non-invasive, and quick including chest X-ray, ECG, ultrasound scan, etc. The treatment of a child suffering from a heart ailment depends on the type of heart problem and the severity of the case. Most heart defects tend to resolve over time with specialized care offered by paediatric cardiology; the other heart problems are treated by medications and while some may also require surgical intervention. Thus, it is very important to take proper paediatric cardiology consultation and evaluate all options to ensure the child receives the best paediatric cardiology care. A healthy child is a happy child.

On the other hand, adult cardiology is a specialised branch of medicine which typically involves diagnosis and treatment of heart conditions and disorders affecting the adults. A person who treats cardiovascular diseases in adults is known as a cardiologist. An adult needs to see a cardiologist when the following symptoms occur:

  • Shortness of breath
  • Dizziness
  • Chest pain
  • Changes in heartbeat and rhythm
  • High blood pressure

Some heart diseases treated by an adult cardiologist include:

  • Atherosclerosis
  • Atrial fibrillation
  • Arrhythmias
  • Congenital heart disease
  • Coronary heart disease
  • Congestive heart disease
  • High blood cholesterol and triglycerides
  • Hypertension
  • Pericarditis
  • Ventricular tachycardia
  • High blood pressure, or hypertension

However, a cardiologist is always the same as a cardiac surgeon. A cardiac surgeon is the one who performs the surgery to treat the medical condition affecting the heart, and in some cases, can be different from a general cardiologist who makes the initial diagnosis.

 In the case of children, the surgeon has to be specialised in treating specific heart conditions which affect the children. Such as cardiac surgeon is called a paediatric cardiac surgeon and the surgery is known as paediatric cardiac surgery. 

The main difference between paediatric cardiac surgery and adult cardiac surgery is the cardiac surgeon performing the surgery and in many ways the type of surgical procedure. A paediatric cardiac surgeon has specialities in performing surgeries to treat heart conditions and diseases affecting the children and infants. On the other hand, an adult cardiac surgeon performs surgeries to treat adults and has no particular specialisation on paediatric surgery. 

The procedure of a general cardiac surgery

As per the traditional method, cardiac surgery involves opening the chest by dividing the chest bone, allowing the surgeon to operate on the heart as per the patient’s condition. During this time, the heart is connected to a heart-lung machine that substitutes the heart functioning. Post a successful procedure, the heart starts beating and functioning on its own and the incision in the chest is sealed which almost takes 6-8 weeks to recover. The sternal wires used to bind the chest bones are left to dissolve eventually, staples made are removed between 7-14 days after surgery, and the glue goes off ultimately on its own. Every surgery has its risks and complications, which will be directed by the cardiac surgeon.

Overall, paediatric cardiac surgery is aimed to treat heart conditions and diseases affecting children unlike adult cardiac surgery aimed to treat the similar in patients above a certain age. 

Hole in baby heart: symptoms, causes, types & treatment

The worst nightmare for a parent is to discover that their child has a heart hole. heart hole is an abnormal opening in the wall that separates the left and right chambers. It is a form of congenital heart defect that is present at birth and changes the normal flow of blood to the heart and hence, can be potentially dangerous depending on the situation. While we all wish for no one to ever experience this condition, but as a responsible parent, one must know when to act and thus, it is imperative to understand what a heart hole means, its symptoms, causes, types, and treatment.

Types of heart hole

Atrial Septal Defect or ASD: This type of heart hole is present in the portion of the septum that separates the right and left chambers of the heart, causing oxygen-rich blood from the left chamber (atrium) to flow into the right chamber rather than flowing into the left ventricle as per normal process. This leads to oxygen-rich blood flowing back into the lungs instead of flowing into the body. ASD could be small or large depending on condition. A small ASD is often harmless and does not require any special treatment, in fact closes on its own as the child grows. Whereas a large ASD cause more blood leakage and could cause potential harm to the baby. These heart holes do not fill up on their own instead require special treatment and care. Most of the cases do not show any signs of a heart hole up until 30 years or later. But if a large ASD is not repaired in time, it might cause right heart failure, irregular heartbeats, stroke, pulmonary hypertension leading to sever complications.

Ventricular Septal Defect or VSD:  A VSD is a type of heart hole where there is an opening in the septum that divides the lower chambers of the heart – the ventricles. This heart hole causes the oxygen-rich blood from the left ventricle to flow into the right ventricle and mix up with the oxygen-poor blood, instead of flowing out of the body through the aorta. A baby might have more than one VSD but in most cases, VSD close as the baby grows up and do not cause any trouble. Large size VSD, however, might cause some symptoms and would require surgery if they do not close on their own. A large VSD could result in heart failure, growth failure, irregular heartbeats, and pulmonary hypertension.

Symptoms of heart hole

Symptoms of a heart hole may not be evident until adulthood and hence, vary on the severity of the situation and the type of heart hole – ASD or VSD. However, in general cases, there is a heart murmur which indicates a heart hole, though not all heart murmurs are an indication of heart hole. More so, symptoms that can potentially indicate a hole in baby’s heart include:

  • Fatigue
  • Extreme tiredness during normal physical activity
  • Shortness of breath
  • Blood and fluid buildup in lungs
  • Fluid accumulation in feet, ankles and legs
  • Irregular heartbeats
  • Low appetite
  • Poor growth

Causes of heart hole

heart hole be it ASD or VSD is a birth defect and is often present at the time of birth and could have formed due to improper development. These are also referred to as congenital heart defects. The clear cause of a heart hole or a hole in baby’s heart cannot be defined. It may be due to hereditary reasons where the parent has a history of heart problem or a congenital heart defect, though this is a very rare case. However, smoking during pregnancy has been highly related to congenital heart problems. Also, a heart hole may be caused due to presence of extra or missing pieces of chromosomes in the baby at the time of formation. Moreover, genetic disorders, such as Down syndrome are also linked to heart hole problems.

Treatment of heart hole

In many cases, a hole in baby’s heart closes on its own as they grow. While in some cases, where trouble symptoms of the heart hole begin to show, treatment becomes necessary depending on the type of hole, locations, size, age of the child, general health, etc.

Most heart holes only need periodic check-ups to check the position of heart hole closure over time. The doctor will advise on the frequency of check-ups depending per case. In many cases (especially non-complicated, small VSDs), proper nutrition also helps close the hole in baby’s heart. In other complicated cases, the doctors might follow either of two treatment options:

Catheter Procedure: In this procedure, a thin, flexible tube is inserted into blood vessel in the leg that reaches that heart. This tube has a small device folded inside, which is pushed out of the catheter when the catheter reaches the septum and placed to cover the heart hole. Within 6 months, normal tissue grows over the device. This is a fairly simple procedure which is also less stressful for the patient. The recovery period is short and fast.

Surgery: Often the last resort, an open-heart surgery is done to repair a heart hole that causes problematic symptoms and is showing no signs of closure on its own. The surgery requires an incision to be made in the chest of the patient, to repair the defect with a special patch to cover the heart hole. The child is then placed on a heart-lung bypass and surgery is performed. The recovery is about 3-4 days long and includes precautions, medications, and utmost care.

Paediatric cardiology- how its different form general cardiology

Today, in India, the rate of heart problems among children under 18 years of age, are not very common but are steeply rising. This is alarming and needs dedicated, world-class care. These problems could be due to multiple reasons such as genetics, birth defects, unhealthy lifestyle, improper growth, smoking and alcohol consumption during pregnancy by the mother or more. Mostly, heart problems in children develop while they are in the uterus and in other cases could also be caused by certain illness during childhood. Cardiac ailments in children can take several forms and need expert medical attention – medications, surgery, post-follow-ups, etc. Paediatric cardiology is the field which is dedicated to provide holistic treatment for children of all ages; it encompasses comprehensive care for patients – from pregnancy, through infancy, childhood, teenage years and later – that have congenital or acquired heart problem.

Children are very different from adults and one such area of vast difference is the cardiac space. The cardiac problems of children vary immensely than those of normal adults; hence, children their care needs to be more specialized and attentive. Many children suffering from heart problems do not show any symptoms and may appear healthy, hence, oftentimes such problems also tend to get ignored until later when they become extremely critical. Paediatric cardiology is a branch of general cardiology that exclusively focuses on children, infants and unborn children with various cardiac problems, and involves diagnosis, prevention and treatment of cardiac defects and problems in them.

One should visit a paediatric cardiologist if the child tends to show any of the below symptoms such as:

  • Blue lips and skin
  • Difficulty in feeding (sweating, breathlessness, etc.)
  • Shortness of breath
  • Palpitations
  • Poor growth
  • Pale skin
  • Fatigue
  • Weak immunity
  • Heart murmur
  • Fainting
  • Lack of physical activeness
  • Chest pain

The symptoms indicate that the heart is not functioning properly and needs medical attention. That said, Paediatric cardiologists are doctors who have expertise in diagnosing and treating children with heart conditions. These paediatric cardiologists’ work closely with cardiothoracic surgeons, paediatricians focussed on other specialities, and expert nurses and staff to provide highly quality, patient-centric and family-oriented care for children. A paediatric cardiologist can treat several conditions for patients such as:

  • Infancy cardiovascular collapse
  • Cardiac failure
  • Newborn cyanosis
  • Heart murmurs
  • Chest pain, palpitations
  • Fatigue and  fainting
  • Congenital heart problem
  • Cardiovascular defects
  • Cardiac abnormalities
  • Heart transplant
  • Aortic valve stenosis
  • Arterial trunk
  • Atrial septal defect (ASD)

Paediatric cardiology entails learning general paediatrics to ensure all-round care of the growing and developing individual. It involves treatment of congenital heart defects, irregular heart beat and rhythm, as well as circulatory function problems. Additionally, Paediatric cardiology involves extensive training and skill in handling and treating children, in the best possible manner.

Paediatric cardiology also involves performing several tests to detect heart problems. These tests are simple, non-invasive, and quick including chest X-ray, ECG, ultrasound scan, etc. The treatment of a child suffering from a heart ailment depends on the type of heart problem and the severity of the case. Most heart defects tend to resolve over time with specialized care offered by paediatric cardiology; the other heart problems are treated by medications and while some may also require surgical intervention. Thus, it is very important to take proper paediatric cardiology consultation and evaluate all options to ensure the child receives the best paediatric cardiology care. A healthy child is a happy child.

Hi, How Can We Help You?