Portfolio of services

Specialized assistance in external consultation

The assistance includes:

• Initial assessment: detailed anamnesis and careful examination of the patient
• Electrocardiography (ECG)
• Echocardiography-Doppler
• Indication of other examinations when necessary for diagnosis¹
• Indication of evaluation for other pediatric specialties if applicable
• Oral and written report on the diagnosis
• Indication of medical treatment when needed, and follow-up

¹ Other methods we use for patient assessment:

• Chest X-ray
• 24-hour holter: performed at the facilities of the Adult Cardiology Service of Sabadell Hospital (SCHS)
• Stress Test or Ergometry (SCHS)
• NMR and Angio NMR
• TAC
• Nuclear Medicine: with calculation of the Isotopic Ejection Fraction and the QP / QS
• Electrophysiological study: performed at the HTR (Arrhythmia Unit of the Hospital S. Joan de Deu in children and the H. Clinic in adolescents).
• Diagnostic or therapeutic cardiac catheterization: HTR

When surgical treatment or therapeutic catheterization is required, a referral to the reference tertiary hospital (HTR) is performed.² in conjunction with which the patient is monitored. Also according to the HTR the:

• Postoperative surgical control
• Control of post-ablation arrhythmias

² The HTRs with which the Cardiology Unit has preferential agreements are Sant Joan de Déu and Maternal and Child Health at Vall d'Hebron Hospital 

Children are evaluated with:

• Buf to cardiac auscultation or alteration of heart sounds
• Babies / infants with symptoms suggestive of heart disease (such as cyanosis, tachypnea, etc.)
• With malformations or syndromes that are associated with heart involvement
• Children and adolescents with chest pain
• Children and adolescents with palpitations or arrhythmia
• Children of parents with heart disease (hypertrophic cardiomyopathy, arrhythmogenic dysplasia)
• Admitted to assess cardiac repercussion of their pathology
• Exposure to chemotherapy to assess cardiac repercussion
• Apnea or Sudden Infant Death Syndrome

Pathologies evaluated:

• Congenital heart diseases
• Arrhythmias: tachyarrhythmias and bradyarrhythmias, conduction disorders
• Non-congenital heart diseases
• Cardiac repercussion of other pathologies
   

Attendance at the Neonatal Unit

The Unit provides cardiac support to the outgoing and premature baby.

• To rule out structural heart disease
• Screening of the arterial duct in the premature
• Study of neonatal arrhythmias
• Cardiological assessment of the baby with other pathologies: hydrops, pulmonary hypertension, metabolopathies, chromosomopathies, shock, etc.

Assistance to patients admitted to the pediatric facility

• Joint medical assistance with the deputy and resident, for evaluation of the follow-up and assessment of the treatment pattern of children admitted for cardiac pathology
• Study of the possible cardiac involvement in other pathologies
• Joint commentary on the Diagnostic Tests

Assistance to patients admitted to the pediatric ICU

• Patients with severe pathologies to rule out heart damage (polytrauma, sepsis, myopathy, etc.)
• Cardiogenic shock
• Congestive heart failure
• Hemodynamically unstable congenital heart disease
• Monitoring, stabilization and treatment of severe arrhythmias that require admission to the ICU

Attendance at the Fetal Doppler Echocardiography Unit

The indications for the fetal echocardiographic study are:

• Cardiac or vessel morphological abnormality on obstetric ultrasound
• Family history of congenital heart disease (pregnant, parents, grandparents, children)
• Fetal malformation to rule out associated heart disease
• Hydrops
• Chromosomopathy
• Fetal arrhythmia
• Autoimmune diseases such as lupus erythematosus, to rule out atrial-ventricular block
• Type I diabetes mellitus (screening for heart disease at 20 weeks and later to rule out hypertrophic cardiomyopathy)
• Neck fold of the 1st quarter

Joint weekly meetings of the Prenatal Committee are held and cases are discussed to assess the best action and follow-up strategies. 

Pairing

The Unit has the following equipment to make a careful assessment in front of the child with suspected heart disease, arrhythmia or congenital heart disease:

• Blood pressure monitor
• 12-channel electrocardiograph, automatic
• Doppler echocardiography device: Vivid S6, of last generation, with possibilities among others to do Doppler ultrasounds, color, pulsed, continuous and tissue, Duplex, Triplex and Auto modes, multifoc control and special sectorial probes for premature babies

Too:

• Computer system for evaluation of image tests (NMR, CT, RX)