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Diagnostic Testing

What do we do?



An EKG records the electrical activity of the heart for each heart beat. It does not record blood pressures or oxygen levels in the heart. The test is painless and involves placing a total of 10 sticky patches (each like a small band-aid) on the skin across the chest and on each arm and each leg. Those patches are connected to lead wires which in turn connect to the EKG machine. The technician or nurse doing the test then can print off a picture of the heart’s electrical activity looking at it from different directions. The EKG helps the cardiologist assess the rhythm of the heart and may give clues to any problems within the chambers or valves of the heart.


An echocardiogram is an ultrasound examination of the heart. Your child’s pediatric cardiologist may request this test in order to look for certain defects of the heart or problems of the strength of the heart. The test takes 20-45 minutes to perform. During the study your child will have three ECG stickers placed on the chest. Then a specialized technician (sonographer) will place the ultrasound probe directly on your child’s chest and record ultrasound pictures of the heart. In order to get the clearest pictures the sonographer will place a small amount of gel on the probe and the skin where the probe is placed. The gel is similar to hair gel and is painless. Pictures of your child’s heart will be taken from standard places on the chest, on the upper part of the belly above the belly button, and at the root of the neck above the collar bones. Sometimes the probe has to be pressed fairly hard in order to get the clearest pictures, but the discomfort from this is usually very mild. There are no known risks or side-effects of an ultrasound examination of the heart.

You can tell your child before the appointment that an echocardiogram might be ordered by the pediatric cardiologist and that the study does not hurt. Three stickers will be necessary, a small amount of gel will be used, and the lighting in the testing room will be darkened in order to get the best pictures possible.

Heart Catheterizations & Angiograms

Cardiac catheterization (or heart catheterization) is a specialized test that provides information about certain heart conditions that cannot be obtained with any other tests. The test is performed while your child is under deep sedation. During the test the pediatric cardiologist advances very thin plastic tubes (called catheters) into the circulation through a vein or artery at the top of your child’s leg or arm. The catheters directly measure blood pressures and oxygen levels within the circulation. Then, the pediatric cardiologist injects medicine (called contrast) within the catheters. This produces X ray movies of the heart called angiograms. All of this information can be very important to decide how serious your child’s heart problem is, and whether further treatment is needed. After the test is completed your child is transferred to a recovery area and is usually discharged home later that same day.

Additional Testing…

  • Fetal Echocardiogram
  • Stress Echocardiogram
  • Transesophageal Echocardiogram (TEE)
  • Event Monitor
  • Holter Monitor
  • Pulse Oximetry
  • Electrophysiologic Study and Radiofrequency Catheter Ablation
  • Interventional Cardiac Catheterization
  • Cardiac Magnetic Resonance Imaging (Cardiac MRI)
Fetal Echocardiogram

Fetal echocardiography is a specialized ultrasound test performed during pregnancy to evaluate the heart of the fetus. The study evaluates the position, size, structure, function and rhythm of the fetal heart. The test is performed in a private room and it is possible for a family member to stay in the room during the test. Gel is applied to the abdomen and an ultrasound transducer is moved over the abdomen to take different images of the structures in the fetal heart. The test typically takes between 30 and 45 minutes, but may take longer based on the position of the fetus. One of the pediatric cardiologists will review the images and discuss the results of the examination with the patient prior to leaving the office.

Stress Echocardiogram

A stress echocardiogram is a stress test that is performed with echocardiography. It demonstrates the response of a child’s heart to exercise and is very useful in monitoring the function of the heart in children with specific diagnoses. The test usually takes 60-90 minutes to perform. First, your child has a brief echocardiogram (ultrasound exam of the heart). After this, your child has a complete stress test. Immediately after your child finishes exercise and has returned to the exam table to rest, a brief echocardiogram is then repeated. The echocardiographic images before and after exercise are compared to check the heart’s ability to pump more forcefully with exercise.

You can reassure your child before the test that a stress echo does not hurt, but your child will be tired after exercising. Many stickers will be placed on the chest and a small amount of gel will be used to do the echocardiograms. The lighting will be darkened in the test room when the echocardiograms are performed in order to get the best pictures possible.

Transesophageal Echocardiogram (TEE)

This is a type of echocardiogram performed by passing a small transducer into the mouth and down the esophagus (the long tube connecting the mouth to the stomach). This study is performed on sedated patients. The TEE images can show certain parts of the heart in greater detail than a surface echocardiogram. This is frequently used during heart operations and during some interventional catheterization procedures.

Event Monitor

An event monitor is a small recording device provided over a 30 day enrollment period to patients who may have off and on but not daily symptoms of heart irregularity or racing and allows the cardiologist to see an EKG recording of the heart rhythm just at the time of those symptoms. The recorders of this type may be attached by lead wires and sticky patches on the chest area or may be hand held or wrist worn in design. In any case, the device only records and stores a brief EKG when it is activated by the patient and is otherwise in a listening or inactive mode. The device may store up to three (3) events and then the data is transmitted over a land line phone later on, when convenient, to the Cardiology office.

Holter Monitor

A Holter monitor is a recording of the heart’s rhythm continuously over 24 hours. The test is painless and involves placing sticky EKG patches on the skin over the chest from which lead wires connect to a digital recorder device that is worn on the belt or in a pouch for younger children. A diary is provided for the 24 hours to recorder daily activities and especially any bothersome symptoms. The test is helpful for patients who have been experiencing daily heart rhythm related symptoms of irregularity or racing. A Holter may also be ordered by the cardiologist to screen for any rhythm problems in patients who have had heart surgery in the past or who may have a family history of some sort of heart rhythm issue.

Pulse Oximetry

This is a simple and painless test which allows measurement of a patient’s oxygen level which would be abnormal in patient with certain types of heart disease and also with lung disease. The test is simple and involves wrapping a small probe around the end of a finger or toe for a few seconds. The probe detects and reads out the heart rate and oxygen level similar to just taking a patient’s temperature.

Electrophysiologic Study and Radiofrequency Catheter Ablation

An electrophysiologic study (EP study) is a special type of heart catheterization that is done to study an abnormal or irregular rhythm of the heart. The pediatric cardiologist advances very thin plastic tubes (called catheters) into the circulation through IV’s that are placed at the top of your child’s leg or arm. The catheters can directly measure the heart’s electrical rhythm and find the exact location of the abnormal heart rhythm. Once this is located, the catheter can then emit a radio wave to permanently disable (or ablate) the source of the problem. This is called a radiofrequency ablation. These procedures are either performed under deep sedation or general anesthesia. Children who have an EP study alone may be discharged later on the same day of the procedure. Those who have an EP study with radiofrequency ablation are usually observed in the hospital overnight and are discharged the following morning.

Interventional Cardiac Catheterization

Sometimes the cardiac catheterization is done not only to diagnose a problem, but to treat it. When special catheters are used to treat a problem this is called an interventional cardiac catheterization. Treatments include opening up blockages in valves or blood vessels that have become too narrow, or closing up holes or blood vessels that should have closed on their own. These procedures are performed under general anesthesia. Children who have had an interventional catheterization are usually observed in the hospital overnight and are discharged the following morning.

Cardiac Magnetic Resonance Imaging (Cardiac MRI)

Cardiac MRI is a non-invasive imaging technique of the heart using magnets and radio waves. It is used in the assessment of heart structure and function and in the assessment of the blood vessels in the chest. It is a very safe test with no known persistent side effects. A contrast agent may be used in some conditions to increase visibility of blood vessels or areas of heart muscle.

Copyright by PCACNY, 2016. All rights reserved.