Several characteristic symptoms indicate that the newborn’s heart is healthy: loud cry, pink skin and vigorous movements. Most babies are born healthy, with a very strong heart. However, a heart defect does not always come to light immediately. This is why cardiology is a branch that is both important and demanding in the case of children.

These symptoms may be a cause for concern for the baby’s parents:

• getting tired very quickly,
• shortness of breath while crying,
• very pale skin with a bluish tinge on the face, lips and tongue,
• severe recurring chest pain,
• fainting and dizziness,
• sucking problems and small weight gain.

Many small heart defects do not give any symptoms. They are diagnosed during periodic examinations or infections. However, these symptoms are the basis for consultation with a paediatric cardiologist. In Warsaw and Łódź, specialist consultations are available in enel-sport centres. The full package of examinations should reassure the parents or, if their child is diagnosed with a disease, help them to plan further treatment.

A paediatric cardiologist is a specialist having expertise in the development of the child’s heart and has special equipment to help assess the condition of this organ. Thus, already during the first visit they can give a much more accurate diagnosis than a paediatrician who has only a stethoscope and access to information obtained during history taking. The most basic and most frequently performed cardiological examinations include the following:

• ECG (electrocardiogram). It involves the use of current to record the electrical activity of the heart. The ECG machine records electrical signals produced by the heart using sensors attached to the child’s arms, legs and chest, and shows them in the form of a graph. The examination is completely painless.
• Echocardiogram (heart ultrasound) – checks the structure of the heart using ultrasound waves. The doctor places a hand-held wand on the child’s chest and sees the picture of the heart and blood flow on the screen. The examination takes up to thirty minutes and is completely painless.
• X-ray – involves taking an X-ray that shows the size and position of the child’s heart. Like examinations mentioned above, it is completely painless.

Before a visit to a paediatric cardiologist, it is good to talk to your child about how the visit will look like. Thanks to this, the child will not be afraid of the doctor and will stay calm.

The case history and results of examinations help the paediatric cardiologist to diagnose, for instance, the following:

• heart failure,
• arrhythmia,
• heart defects (e.g. mitral regurgitation, aortic regurgitation, mitral stenosis, aortic stenosis and tricuspid regurgitation).

Even if a child is diagnosed with a heart defect, this does not necessarily mean an immediate operation. In the case of babies, surgery is usually postponed if it is not necessary. Not all defects are operated on. Sometimes suitable treatment is sufficient.

It is possible that further diagnostic procedures will have to be performed in the hospital, as sometimes a paediatric cardiologist refers the young patients for detailed blood tests or cardiac catheterisation. Cardiac catheterisation involves insertion of a small tube (catheter) into the vein. The tip of the catheter is passed up to the heart via blood vessels. In this way, the blood pressure in the ventricles and atria is measured and samples are taken to assess oxygen saturation. Sometimes the catheter is also used to inject contrast medium – the change in colour makes it possible to assess the blood flow and makes the heart cavities visible. The cardiac catheterisation procedure is carried out under anaesthetic and lasts about two hours.

If the procedure is postponed until the child is a few years old, parents should strictly follow doctor’s instructions, including those concerning medication the child should take.