Pediatric Cardiology is a medical specialty dedicated to the prevention, diagnosis and treatment of heart diseases. Its intervention begins during pregnancy and goes to early adulthood (18 years). In adults, heart diseases are mainly due to normal “wear” throughout life and exposure to risk factors. Thus, they are acquired diseases. On the contrary, in children, most heart diseases result from cardiac development alterations during fetal life . They are congenital heart defects or malformations. It is estimated that out of every 1000 children born, 8 have congenital heart disease. Of these, around half will require some invasive treatment (surgery or therapeutic cardiac catheterization) throughout their lives. There are many congenital heart defects. These include, for example: Aortic coarctation ; interatrial communication; Patent ductus arteriosus ; Fallot tetralogy ; Cardiomyopathies. In addition to congenital problems, there are also multiple acquired diseases that affect different cardiac components , for example: The valves (rheumatic fever, endocarditis); The myocardium or heart muscle (myocarditis); The pericardium (pericarditis); Coronary arteries (Kawasaki syndrome) and great vessels. In both congenital and acquired heart diseases, early diagnosis and regular monitoring are the key to adequate treatment. And this is the role of pediatric cardiologists. Referral to Pediatric Cardiology The intervention of a pediatric cardiologist may be necessary as early as pregnancy. It begins with a fetal echocardiogram, which allows a complete assessment of the fetal heart. This intervention generally takes place on the recommendation of the obstetrician who monitors the pregnant woman. Among the indications that justify it are: Difficulty or doubts in fetal cardiac assessment during routine pregnancy exams; Pregnancy achieved by medically assisted procreation techniques; Maternal risk factors, for example autoimmune diseases and diabetes; Fetal risk factors, e.g. risk markers for trisomy, twin pregnancies. After birth, evaluation by pediatric cardiology may be requested by the pediatrician or another attending physician. The reasons for this referral are diverse and vary according to the child's age, including, for example: Heart murmur; Difficulty breathing; Cyanosis; Suspected arrhythmia (detection of palpitations, perception of very fast or slow heartbeats); Chest pain; Fainting; Tiredness; Hypertension; Family history of heart disease; Suspected systemic disease. Another frequent indication and no less important, is the assessment in a sport context, for intense or competitive sports practice. Despite its particularities, pediatric cardiology uses the same diagnostic tools as adult cardiology, including: Electrocardiogram, to evaluate the cardiac electrical component; Doppler echocardiogram, to evaluate cardiac anatomy; 24-hour Holter, which records cardiac electrical activity for 24 hours; Stress test, which analyzes the electrical activity of the heart before, during and after physical effort up to a standardized maximum for the age group; Ambulatory blood pressure monitoring, which studies blood pressure variations over 24 hours. Remember that a child's heart is not a miniature of an adult heart. If observation by pediatric cardiology was recommended, that’s because it is necessary. Author: Sofia Granja Meet the Pediatric Cardiology clinical team at the Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
