General Pediatric Cardiology
In our general pediatric cardiology clinic, we provide consultation for patients with congenital and acquired heart disease. Some examples include:
- Evaluation of heart murmurs
- Evaluation of chest pain
- Congenital heart defects
- Cardiac clearance for sports
- Screening evaluations for families with a history of sudden cardiac death
- Hypertrophic cardiomyopathy and other cardiomyopathies (diseases of the heart muscle)
- Muscular dystrophies
- Kawasaki disease and other acquired conditions
- Connective tissue disorders (like Marfan syndrome)
- Evaluation of palpitations
- Heart rhythm abnormalities
- Evaluation of syncope (fainting)
- Long QT syndrome
- Cardiac clearance for anesthesia
- High blood pressure - see Preventive Cardiology
- High cholesterol/hyperlipidemia - see Preventive Cardiology
- Obesity - see Preventive Cardiology
Frequently Asked Questions
What should I expect at my first cardiology visit?
What is a murmur?
What is a congenital heart defect?
What if my child has a heart defect?
What is an interventional catheterization?
What if my child needs heart surgery?
What is an arrhythmia?
What if my child has an arrhythmia?
What is an electrophysiologist?
Will my child still be able to participate in sports?
Will my child with congenital heart disease develop normally?
What if there is an emergency or my child needs to be seen after hours?
What is a murmur?
What is a congenital heart defect?
What if my child has a heart defect?
What is an interventional catheterization?
What if my child needs heart surgery?
What is an arrhythmia?
What if my child has an arrhythmia?
What is an electrophysiologist?
Will my child still be able to participate in sports?
Will my child with congenital heart disease develop normally?
What if there is an emergency or my child needs to be seen after hours?
What should I expect at my first cardiology visit?
You should plan on spending about two hours in the cardiology clinic at your first visit. To save time at the first visit, you may want to fill out a registration form and other paperwork (see New Patients) before coming, and bring this to the appointment. Your child will be weighed and measured, and vital signs including blood pressure will be taken. Most clinic patients also undergo an electrocardiogram. Your appointment will include a visit with the cardiologist, as well as testing needed to establish a diagnosis or to help decide on appropriate treatment. We make every effort to perform all necessary testing on the day of your first visit. Testing results are provided on the same day, so that when you leave, you have as much information as possible. Before you leave, we will discuss with you your child's diagnosis if available, as well as any treatment, restrictions, or follow-up plans.
What is a murmur?
A murmur is a sound your doctor hears when listening to the heart with a stethoscope. Murmurs are caused by the sound of blood moving through the heart. Some murmurs are due to structural abnormalities of the heart, such as a hole in the heart or a valve abnormality. But, most murmurs are normal and not due to any heart problem. These normal murmurs are called innocent, functional, or benign murmurs. Innocent murmurs are very common in children. Your cardiologist can determine whether your child's murmur is innocent by listening to your child's heart with a stethoscope. Sometimes, an echocardiogram (an ultrasound of the heart) is needed to determine whether any structural abnormalities are present.
What is a congenital heart defect?
A congenital heart defect is a structural abnormality of the heart that is present from birth. These defects occur very early in pregnancy, often before the mother knows she is pregnant. In most cases, we don't know what caused a defect, and nothing could have been done to prevent it.
What if my child has a heart defect?
Heart defects are the most common type of birth defect. They do not necessarily affect a child's activity, development, or quality of life. Most heart defects are minor; these defects require follow-up with a cardiologist but usually do not require treatment. When treatment is needed, this can be in the form of medication, an interventional cathaterization procedure, or surgery. Please click here for information on specific defects.
What is an interventional catheterization?
Because of advances in technology, many heart defects can now be treated without surgery. Instead, they can be treated using a cardiac catheterization procedure. These procedures are performed by a pediatric interventional cardiologist, who has undergone specialized training beyond general pediatric cardiology. Pediatric interventional cardiologists treat both children and adults with congenital heart disease. The type of procedure performed depends on the type of heart defect being treated. For example, special devices can be used to close holes in the heart, balloons can be used to treat valve abnormalities, and stents can be used to open narrowed blood vessels. These procedures do not involve a chest incision and require only an overnight stay in the hospital. For more on interventional catheterization, click here.
What if my child needs heart surgery?
Heart surgery for patients with congenital heart disease is performed by a congenital heart surgeon. This is a surgeon who is specially trained and experienced in treating children and adults with congenital heart defects. Most of our patients are referred to congenital surgeons in Portland for their procedure, in order to provide the highest quality care both during and after surgery. Before making a decision to proceed with surgery, each patient's case is reviewed by a group of pediatric cardiologists, adult congenital cardiologists, and congenital heart surgeons, to determine the best course of treatment. The medical team at the referring institution will maintain close communication with your local pediatric cardiologist during the hospital stay and at the time of discharge. After discharge, all follow-up care can take place locally.
You should plan on spending about two hours in the cardiology clinic at your first visit. To save time at the first visit, you may want to fill out a registration form and other paperwork (see New Patients) before coming, and bring this to the appointment. Your child will be weighed and measured, and vital signs including blood pressure will be taken. Most clinic patients also undergo an electrocardiogram. Your appointment will include a visit with the cardiologist, as well as testing needed to establish a diagnosis or to help decide on appropriate treatment. We make every effort to perform all necessary testing on the day of your first visit. Testing results are provided on the same day, so that when you leave, you have as much information as possible. Before you leave, we will discuss with you your child's diagnosis if available, as well as any treatment, restrictions, or follow-up plans.
What is a murmur?
A murmur is a sound your doctor hears when listening to the heart with a stethoscope. Murmurs are caused by the sound of blood moving through the heart. Some murmurs are due to structural abnormalities of the heart, such as a hole in the heart or a valve abnormality. But, most murmurs are normal and not due to any heart problem. These normal murmurs are called innocent, functional, or benign murmurs. Innocent murmurs are very common in children. Your cardiologist can determine whether your child's murmur is innocent by listening to your child's heart with a stethoscope. Sometimes, an echocardiogram (an ultrasound of the heart) is needed to determine whether any structural abnormalities are present.
What is a congenital heart defect?
A congenital heart defect is a structural abnormality of the heart that is present from birth. These defects occur very early in pregnancy, often before the mother knows she is pregnant. In most cases, we don't know what caused a defect, and nothing could have been done to prevent it.
What if my child has a heart defect?
Heart defects are the most common type of birth defect. They do not necessarily affect a child's activity, development, or quality of life. Most heart defects are minor; these defects require follow-up with a cardiologist but usually do not require treatment. When treatment is needed, this can be in the form of medication, an interventional cathaterization procedure, or surgery. Please click here for information on specific defects.
What is an interventional catheterization?
Because of advances in technology, many heart defects can now be treated without surgery. Instead, they can be treated using a cardiac catheterization procedure. These procedures are performed by a pediatric interventional cardiologist, who has undergone specialized training beyond general pediatric cardiology. Pediatric interventional cardiologists treat both children and adults with congenital heart disease. The type of procedure performed depends on the type of heart defect being treated. For example, special devices can be used to close holes in the heart, balloons can be used to treat valve abnormalities, and stents can be used to open narrowed blood vessels. These procedures do not involve a chest incision and require only an overnight stay in the hospital. For more on interventional catheterization, click here.
What if my child needs heart surgery?
Heart surgery for patients with congenital heart disease is performed by a congenital heart surgeon. This is a surgeon who is specially trained and experienced in treating children and adults with congenital heart defects. Most of our patients are referred to congenital surgeons in Portland for their procedure, in order to provide the highest quality care both during and after surgery. Before making a decision to proceed with surgery, each patient's case is reviewed by a group of pediatric cardiologists, adult congenital cardiologists, and congenital heart surgeons, to determine the best course of treatment. The medical team at the referring institution will maintain close communication with your local pediatric cardiologist during the hospital stay and at the time of discharge. After discharge, all follow-up care can take place locally.
What is an arrhythmia?
The electrical (conduction) system of the heart is responsible for making sure that the heart rate is normal, and that all the heart chambers are working in synchrony with each other. An arrhythmia is an abnormality of the heart's conduction system, usually meaning that the heart is going too fast or two slow. There are many types of arrhythmias. Most arrhythmias are safe, but some are not. People who have arrhythmias may have no symptoms, or may experience symptoms like palpitations or fainting. Sometimes, looking at an electrocardiogram (EKG) can help diagnose an arrhythmia, but usually other testing, called ambulatory monitoring, is needed.
What if my child has an arrhythmia?
There are often several different treatment options for arrhythmias. The options depend on the type of arrhythmia and how safe or unsafe the arrhythmia is. In some cases, it is fine not to treat an arrhythmia at all. Other arrhythmias require treatment with medicines. Some arrhythmias can be treated with an ablation procedure, or placement of a pacemaker. In the rare case of a dangerous arrhythmia, placement of a defibrillator may be necessary. Your cardiologist may involve an electrophysiologist to assist in treatment of some arrhythmias.
What is an electrophysiologist?
An electrophysiologist is a cardiologist who specializes in abnormalities of the heart's electrical system. A pediatric electrophysiologist has extensive training in the treatment of arrhythmias in children, and has an understanding of changes in the heart's electrical system that can occur in congenital heart disease. For adults with congenital heart disease who also have arrhythmias, involvement of a pediatric electrophysiologist is very important. An electrophysiologist also has special training in performing electrophysiology studies, ablation procedures, and implantation of pacemakers and defibrillators.
Will my child still be able to participate in sports?
During the early childhood and elementary school years, children with congenital heart disease are not restricted from physical activities. During the middle school and high school years, most children with congenital heart disease continue not to require activity restrictions and participate successfully in recreational and competitive sports. However, for some children, participation in certain types of sports in unsafe. This does not mean that the child cannot be physically active. The restrictions that are recommended depend on the type and severity of the child's heart problem. For example, some children should not participate in contact sports, while others should not particiapte in any competitive activity. With your permission, we will communicate with your child's school nurse, coach, or P.E. teacher to provide the safest exercise program possible. Sometimes, restrictions are lifted after a child has undergone treatment for their heart problem. In all cases, our goal is to maintain the best possible quality of life for your child. We encourage you to discuss potential activity restrictions with your cardiologist as early as possible, since being aware of this issue early on is very helpful in preparing both child and family.
The electrical (conduction) system of the heart is responsible for making sure that the heart rate is normal, and that all the heart chambers are working in synchrony with each other. An arrhythmia is an abnormality of the heart's conduction system, usually meaning that the heart is going too fast or two slow. There are many types of arrhythmias. Most arrhythmias are safe, but some are not. People who have arrhythmias may have no symptoms, or may experience symptoms like palpitations or fainting. Sometimes, looking at an electrocardiogram (EKG) can help diagnose an arrhythmia, but usually other testing, called ambulatory monitoring, is needed.
What if my child has an arrhythmia?
There are often several different treatment options for arrhythmias. The options depend on the type of arrhythmia and how safe or unsafe the arrhythmia is. In some cases, it is fine not to treat an arrhythmia at all. Other arrhythmias require treatment with medicines. Some arrhythmias can be treated with an ablation procedure, or placement of a pacemaker. In the rare case of a dangerous arrhythmia, placement of a defibrillator may be necessary. Your cardiologist may involve an electrophysiologist to assist in treatment of some arrhythmias.
What is an electrophysiologist?
An electrophysiologist is a cardiologist who specializes in abnormalities of the heart's electrical system. A pediatric electrophysiologist has extensive training in the treatment of arrhythmias in children, and has an understanding of changes in the heart's electrical system that can occur in congenital heart disease. For adults with congenital heart disease who also have arrhythmias, involvement of a pediatric electrophysiologist is very important. An electrophysiologist also has special training in performing electrophysiology studies, ablation procedures, and implantation of pacemakers and defibrillators.
Will my child still be able to participate in sports?
During the early childhood and elementary school years, children with congenital heart disease are not restricted from physical activities. During the middle school and high school years, most children with congenital heart disease continue not to require activity restrictions and participate successfully in recreational and competitive sports. However, for some children, participation in certain types of sports in unsafe. This does not mean that the child cannot be physically active. The restrictions that are recommended depend on the type and severity of the child's heart problem. For example, some children should not participate in contact sports, while others should not particiapte in any competitive activity. With your permission, we will communicate with your child's school nurse, coach, or P.E. teacher to provide the safest exercise program possible. Sometimes, restrictions are lifted after a child has undergone treatment for their heart problem. In all cases, our goal is to maintain the best possible quality of life for your child. We encourage you to discuss potential activity restrictions with your cardiologist as early as possible, since being aware of this issue early on is very helpful in preparing both child and family.
Will my child with congenital heart disease develop normally?
In most cases, yes. Some children with very significant heart defects, or those who have undergone open heart surgery, may have changes in their development. Those who have open heart surgery during infancy seem to be the most at risk. Developmental issues are usually subtle, and may involve areas like speech, attention, or hand-eye coordination. Because of this, we recommend developmental assessments for all of our patients with complex congenital heart disease, especially those who have undergone surgery in the first year of life. This is also recommended for anyone who has general concerns about their child's development. For children five years of age and younger, developmental assessments can be obtained free of charge through the Alyce Hatch Center at (541)312-1947. Assistance for children of all ages can be obtained through the High Desert Education Service District.
What if there is an emergency or my child needs to be seen after hours?
Your child can be seen after hours in several locations, including the Emergency Departments of St. Charles Medical Center, or some Urgent Care clinics. Your child's pediatrician may also have evening or weekend clinic hours. In each case, your child's pediatric cardiologist is available 24 hours a day and can be paged directly by your child's emergency room doctor or pediatrician. In the rare event that your local pediatric cardiologist is out of town, pediatric cardiologists in Portland are available for assistance in treatment of any heart-related issues, and can be reached through our office or through the St. Charles Medical Center paging system. If you need to speak with your cardiologist after hours, please call our office (see Contact Us), and ask the answering service to have the cardiologist paged. In cases of true emergency, please call 911.
In most cases, yes. Some children with very significant heart defects, or those who have undergone open heart surgery, may have changes in their development. Those who have open heart surgery during infancy seem to be the most at risk. Developmental issues are usually subtle, and may involve areas like speech, attention, or hand-eye coordination. Because of this, we recommend developmental assessments for all of our patients with complex congenital heart disease, especially those who have undergone surgery in the first year of life. This is also recommended for anyone who has general concerns about their child's development. For children five years of age and younger, developmental assessments can be obtained free of charge through the Alyce Hatch Center at (541)312-1947. Assistance for children of all ages can be obtained through the High Desert Education Service District.
What if there is an emergency or my child needs to be seen after hours?
Your child can be seen after hours in several locations, including the Emergency Departments of St. Charles Medical Center, or some Urgent Care clinics. Your child's pediatrician may also have evening or weekend clinic hours. In each case, your child's pediatric cardiologist is available 24 hours a day and can be paged directly by your child's emergency room doctor or pediatrician. In the rare event that your local pediatric cardiologist is out of town, pediatric cardiologists in Portland are available for assistance in treatment of any heart-related issues, and can be reached through our office or through the St. Charles Medical Center paging system. If you need to speak with your cardiologist after hours, please call our office (see Contact Us), and ask the answering service to have the cardiologist paged. In cases of true emergency, please call 911.