What to Expect

Pediatric Cardiology

Your Office Visit

Our team is trained in caring for young patients, and our goal is to make your visit as stress-free as possible.

Preparing for your visit:
  • If your child is a new patient, you will receive a new patient packet. Please complete the packet and bring it to your visit.
  • Please arrive 10-15 minutes early.
Be sure to bring:
  • Identification, such as a drivers license
  • Insurance card
  • Proof of legal guardianship or medical power of attorney if anyone other than the custodial parent is bringing the child to the appointment
  • List of your child's medications
  • Any medical records relating to your child's condition
During your visit:
  • Depending on the reason for your visit, an echocardiogram and electrocardiogram may be done.
  • A nurse will review the packet with you and may ask for additional information.
  • The nurse will weigh your child and take vitals including heart rate, temperature and blood pressure in an arm and a leg.
  • You will then meet your medical provider, who will conduct an exam, carefully explain the necessary testing and treatment, and answer all your questions.
If you have any questions before or after your visit, call our office at (406) 257-8992.

What is an echocardiogram?

Listening to baby's heart
  • An echocardiogram (usually referred to as an echo) is an ultrasound of the heart. This imaging technique uses sound waves to create an image of the heart.
  • An echocardiogram evaluates the anatomy of the heart, including the valves and walls, and can show any abnormalities, such as holes in the heart.
  • An echocardiogram also demonstrates heart function, or how well the heart muscle squeezes and relaxes.
  • An echocardiogram does not use radiation and is not painful or uncomfortable. The person who performs the echocardiogram has specialized training in heart anatomy and ultrasound. He or she will use ultrasound gel, which is necessary for transmission of sound waves.
  • Most children have no trouble with echocardiograms. The study does require your child to be still for 20 to 30 minutes. We have movies and a calm atmosphere to support this. The most challenging ages are between 4 months and 3 years of age, and an echocardiogram can also be challenging for patients with developmental delays, sensory integration disorders or other special conditions.
  • In rare cases, a complete echocardiogram is not possible because of the above challenges, and we will sometimes plan for your child to come back when he or she is older. If we decide with your family and your primary care provider that the echocardiogram should be done soon, we can schedule an echocardiogram with sedation. This is done at the hospital with an anesthesiologist.

What is an electrocardiogram?

  • An electrocardiogram is also known as an EKG or ECG.
  • This is a study of the electrical activity of the heart.
  • An electrocardiogram involves 12 stickers on the chest for about one minute. The actual tracing only takes 10 seconds to complete.
  • An electrocardiogram does not use radiation and does not cause pain or discomfort.
  • Most children are able to have an electrocardiogram without sedation.

What is a Holter monitor?

  • A Holter monitor is a 24-hour or 48-hour test of the electrical activity of the heart. Your child will wear the monitor under his or her clothing and it will not be visible. There are various options. Most have five stickers that attach to a small box with wires. The box is the size of a phone and can be clipped to clothing or kept in a pocket. Some insurance companies will cover a wireless monitor, which is easier to wear while playing sports.
  • The reasons for using a Holter monitor include palpitations (feelings of the heart racing or going too slow, extra beats or skipped beats), fainting spells, chest pain, or to evaluate for abnormal rhythms in children with congenital heart disease or known rhythm abnormalities.

What is a 30-day monitor?

  • A 30-day monitor is also known as an event monitor. This is a test of the electrical activity of the heart. Your child will wear the monitor under his or her clothing and it will not be visible. There are various options. Most have five stickers that attach to a small box with wires. The box is the size of a phone and can be clipped to clothing or kept in a pocket. Some insurance companies will cover a wireless monitor, which is easier to wear while playing sports.
  • The reasons for a 30-day monitor include palpitations (feelings of the heart racing or going too slow, extra beats or skipped beats) and fainting spells that happen rarely and that would not likely be seen on a 24- or 48-hour monitor.

What is an exercise study?

  • An exercise study is also known as a stress test, cardiopulmonary exercise study or a treadmill test.
  • This test is performed on a treadmill or a stationary bicycle, while we monitor your child’s heart rate, blood pressure, breathing, and degree of oxygen and carbon dioxide exchange.
  • An exercise study may be indicated if your child has concerning symptoms with exercise, including chest pain, fainting, dizziness or palpitations. Children with congenital heart disease, abnormal heart muscle (cardiomyopathy) or known rhythm abnormalities often require an exercise study to evaluate whether they are safe to participate in strenuous activities such as sports, dance or other forms of exercise.

What is a cardiac CT scan?

  • A CT (computed tomography) scan is a detailed scan of the heart.
  • Occasionally, a CT scan is required to evaluate for abnormalities of the coronary arteries or the aorta.
  • A CT scan does use radiation. This is minimized as much as possible for pediatric patients.
  • Sometimes cardiac MRI (magnetic resonance imaging) is an alternative to CT.
  • A benefit of cardiac CT over MRI is that it is much faster and usually does not require anesthesia or sedation.

What is a cardiac MRI?

  • An MRI (magnetic resonance imaging) scan is a detailed scan of the heart.
  • A cardiac MRI is used to evaluate the heart muscle and heart function, and can also be used to evaluate the aorta or pulmonary artery.
  • An MRI does not use radiation.
  • A cardiac MRI takes between 60 and 90 minutes, and requires a patient to be still and be able to follow directions.
  • Children younger than 7 usually require sedation for a cardiac MRI. Between the ages of 7 and 10, we usually decide with the parents and the child whether they will require sedation. Children older than 10 can often complete a cardiac MRI without sedation.

What is an electrophysiology study?

  • An electrophysiology study is a procedure that is done at the hospital with anesthesia.
  • During an electrophysiology study, a specialized cardiologist called an electrophysiologist uses catheters placed in leg veins to access the heart.
  • An electrophysiology study may be performed for different reasons:
  • An electrophysiology study often includes an ablation, in which special catheters are used to treat an abnormal heart rhythm. These catheters may be hot (radiofrequency ablation) or cold (cryoablation).

What is a fetal echocardiogram?

  • A fetal echocardiogram is an ultrasound of a baby’s heart prior to birth.
  • Not every pregnant woman requires a fetal echocardiogram. The reasons for a fetal echocardiogram include:
    • An abnormal 20-week anatomy scan
    • Family history of congenital heart disease
    • Concern about abnormal fetal heart rhythm
    • Family history of abnormal heart rhythm in young people
    • Mother with diabetes
    • Mother with a rheumatologic disorder such as lupus, Sjögren’s syndrome, hypothyroidism, hyperthyroidism or rheumatoid arthritis
    • Family history of trisomy 13, 18 or 21
    • Other reasons may be determined by your obstetrician or perinatologist
  • A fetal echocardiogram can be performed at Rocky Mountain Heart & Lung or Montana Perinatal Center.

What is a heart catheterization?

  • A heart catheterization is a procedure that is done at the hospital with anesthesia.
  • During a heart catheterization, a specialized cardiologist uses catheters placed in leg or arm veins or arteries to access the heart.
  • A heart catheterization may be performed for different reasons:
  • A heart catheterization usually involves some radiation.

What is nuclear imaging?

  • Nuclear imaging is a type of radiology study that evaluates the function of the heart and the health of the heart muscle.
  • This can also be called scintigraphy, SPECT or PET.
  • This study may be ordered if your child has a history of congenital heart disease and is having trouble with exertion, if there are concerns about your child’s coronary arteries or for cardiomyopathy.
  • A radiopharmaceutical tracer is given through a vein and undergoes spontaneous radioactive decay to emit radiation (usually gamma rays). The radiation is detected by external cameras to form images.
  • This test does involve radiation.

What are orthostatic vital signs?