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In the pediatric cardiology units we take care of fetuses (in uterus), newborns, children and adults who suffer from congenital heart defects or specific acquired heart diseases.
Outpatient clinics - Pediatric cardiology consultation
Newborns and children are referred to the tertiary care clinic after a pediatrician, a cardiologist or a general practitioner suspected of a cardiac in-born or acquired condition.
Cardio-genetic clinics function in Israel for the last decade.
These new and unique clinics were established, as joined projects of the Pediatric Cardiology Units and the Departments of Genetics. A cardiologist and a geneticist examine the child and question the parents in order to offer specific genetic counseling to the family of the affected child or fetus. Explanations about the condition and its transmission probabilities are given and discussed with the family. Pregnant women carrying a fetus with a cardiac defect that was diagnosed by ultra-sonography are also referred. In addition to a thorough explanation of the disease and planning of the birth, emphasis is put on postnatal care and prognosis.
Non-invasive Laboratories
Fetal echocardiography
Pregnant women who carry a fetus suspected to have a cardiac condition, or women who have a history of cardiac defects in the family, are referred to undergo this examination. Also, high-risk pregnant women suffering of a systemic disease such as Diabetes Mellitus or Lupus, routinely undergo fetal echocardiography. The examination is performed typically between the 17th and the 22nd week of gestation. However, in some cases where the development of a cardiac defect is highly suspected, fetal echocardiography will already be performed at the 14th week of gestation. In rare cases, trans-vaginal fetal echocardiography will be performed even earlier, i.e. at the 11th week of gestation.
Newborns, infants and children who seem to suffer of heart disease are examined by echocardiography to determine their status.
Pediatric exercise test
This test is performed similarly to the adult exercise test, however, with an age-adjusted target heart rate. In contrast to adults, the indication to perform this test in children is usually not ischemic heart disease, but to assess the cardiac function after surgery or to investigate a cardiac arrhythmia during effort.
Pediatric Holter
In children, 24-hour ECG monitoring is mainly used to assess a congenital or acquired arrhythmia.
Invasive Laboratories
Pediatric cardiac catheterization
In children, cardiac catheterization is rarely performed as a diagnostic procedure since most of the structural and functional heart diseases are diagnosed by echocardiography. Some catheterizations are due to assess hemodynamic before surgery.
In the majority of cases, the baby or the child will be referred for a transcutaneous procedure such as coil closure of a patent ductus arteriosus (PDA), device closure of an atrial septal defect (ASD), or creating a communication through the inter-atrial septum in case that the newborn has transposition of great arteries.
Intra-operative and intra-catheterization trans-esophageal echocardiography (TEE)
TEE is performed during surgical or transcutaneous therapeutic interventions in the catheterization laboratory to provide on-line imaging of the heart.
In-hospital services
In addition, the pediatric cardiologists of the unit take care of children admitted to different Departments of the Hospital, namely:
1. Pediatrics
2. Neonatology
3. Pediatric intensive care unit
4. Pediatric surgery |
