The paediatric cardiologist can often tell by examination whether a heart murmur is significant. The simple tests include a chest X-ray and an electrocardiogram. The chest X-ray is used to tell the shape and size of the heart and the state of the lungs. An electrocardiogram analyses the electrical activity of the heart. If the clinical electrocardiogram and simple investigation is normal, we stop at that and reassure the parents.
If there is suspicion, an electrocardiogram is ordered. This is an ultrasound examination of the heart, like what the obstetrician will perform to look at the fetus in pregnant women.
Yes and no. The heart is formed by the eighth week of pregnancy. Antenatal ultrasound can be used to look at the heart at about 12 weeks onwards to look for heart defects. The majority of heart defects picked up antenatally are major and often serious abnormalities of the heart. Minor defects like small holes and mild valve defects, for example, will slip through this screening process.
The defect has to be carefully characterised and the type of treatment that is available and the long term outcome of treatment will have to be discussed with the parents. Depending on the type of defect, the stage of pregnancy, the philosophy of parents, their religious beliefs and family support, a decision is made to carry on to term or to terminate the pregnancy.
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