To diagnose and evaluate valvular abnormalities

To measure and evaluate the size of the heart’s chambers and valves

To help diagnose cardiomyopathies and atrial tumors

To evaluate cardiac function or wall motion after myocardial infarction (rare in children)

To detect pericardial effusion or mural thrombi

Make sure that the consent form is signed by the child’s parents or legal guardians.

Tell the child that he may be asked to breathe in and out slowly or to hold his breath while changes in heart function are recorded.

Stress the importance of holding still during the test because movement may distort results. Assist as necessary.

Administer mild sedation if needed, as ordered. Use distractions, such as a videotape, to help calm the child.

Explain that the procedure is painless.

Explain to the child and his parents that the test takes 15 to 30 minutes.

The child is placed in the supine position, and conductive gel is applied to the third or fourth intercostal space to the left of the sternum. The transducer is placed directly over it.

The transducer is systematically angled to direct ultrasonic waves at specific parts of the heart.

During the test, the oscilloscope screen is observed; significant findings are recorded on a strip chart recorder or on a videotape recorder.

For a left lateral view, the child is placed on his left side.

Doppler echocardiography may also be used. Color flow simulates red blood cell flow through the heart valves. The sound of blood flow may also be used to assess heart sounds and murmurs as they relate to cardiac hemodynamics.