November 18th, 2013 | Soccer. Baseball. Basketball. Gymnastics. If your child plans to participate in an organized sport activity, they’ll need more than just the required gear and equipment; They’ll also need a yearly physical exam. While an annual physical is fairly comprehensive, your physician may recommend additional screening for heart-related… Continue Reading
An Experienced, Interdisciplinary Team of Pediatric Cardiac Specialists
The clinical insight of the physicians treating pediatric cardiac patients at the Riley Heart Center is matched by few facilities in the United States. This has created an unparalleled level of trust among referring physicians throughout Indiana and the Midwest.
Children receiving cardiac treatment at Riley Hospital for Children at Indiana University Health do so in the only hospital in the state dedicated exclusively to the acute care of pediatric patients. Pediatric experts in every medical and surgical specialty and subspecialty are available 24 hours a day to address any additional health problems a child may face.
Diagnostic Technologies and Expertise
Complementing their expertise in the hands-on physical exam, pediatric cardiologists at Riley Hospital for Children at IU Health use a range of tests to evaluate defects of the heart and blood vessels. These tests include echocardiography, EKG, X-ray, ambulatory EKG, exercise tests, electrophysiologic tests (testing the electrical system of the heart), MRI and diagnostic heart catheterization, among others.
Our experienced team performs:
Our team also leads the Adult Congenital Heart Disease Program (jump link to below), which provides continuing care to adolescents and adults who have congenital heart disease. We also offer the Preventive Pediatric Cardiology Program (jump link to below), which helps address health issues in childhood that can lead to heart disease as an adult.
One of the most useful tools for assessing congenital heart defects is the echocardiogram. This test uses noninvasive, high-frequency sound waves to show complex cardiac anatomy and physiology. It’s an essential tool that has eliminated the need for heart catheterization for many defects. Our clinicians with additional specialized training annually perform more than 10,000 pediatric and fetal echocardiograms, including about 1,100 fetal echoes, and a staff of pediatric cardiologists interprets them. Their expertise is widely recognized among other hospitals in the Midwest, which rely on Riley at IU Health cardiologists to annually interpret more than 3,100 echoes from their own institutions.
Riley at IU Health was the first in Indiana to have a pediatric echo lab accredited by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories. In addition to traditional echoes, our cardiologists who treat more complex cases often perform transesophageal echoes (TEE) when they need additional views. A TEE also can guide interventional catheterizations for immediate assessment in the operating room.
Echocardiograms are performed throughout the Riley Heart Center, including the operating room and catheterization lab, to provide assessment during a procedure or to guide surgical interventional procedures. Moreover, our echo lab was one of the first all-digital labs in the state. We continue to apply new technologies and systems that ensure that tests can be accessed and reviewed 24 hours a day to help with patient care at Riley at IU Health and throughout the state.
The cardiac MRI program at Riley at IU Health is unique in the state of Indiana. This program provides thorough and in-depth details on cardiac structure and function in children and young adults with all types of heart disease. We perform nearly 200 highly specialized cardiac MRI exams annually. An MRI does not use ionizing radiation (as X-rays do) and is not an invasive procedure. MRIs often provide an alternative to heart catheterization. This makes cardiac MRI a very easy procedure for many children to undergo. Cardiac MRI can also answer questions that echocardiography may not be able to answer. Cardiac MRI is also often used in making decisions about and planning for heart surgery. Riley at IU Health has the only pediatric cardiologist and pediatric radiologist in the state qualified to perform and interpret cardiac MRI studies.
Rapidly advancing catheterization [link: http://iuhealth.org/riley/cardiology/cardiac-catheterization/] technology allows the diagnosis and repair of the most complex cardiac defects. Some defects that only a few years ago would require surgery can now be treated with catheter-based techniques. Our interventional pediatric cardiologists have been at the forefront of those advancements. A Riley at IU Health cardiologist performed a balloon valvuloplasty on the smallest patient to successfully undergo the procedure—the baby weighed less than 2 pounds. Our cardiologists were among a small group of experts nationwide involved in clinical research trials for Amplatzer Septal, Duct Occluder and Nit-Occlud devices that are used in treating atrial septal defects (ASD) and patent ductus arteriosus (PDA). Numerous clinical trials of other medical devices are ongoing.
A team model of care shapes the treatment in the catheterization laboratory and recovery within the Riley Heart Center. Pediatric interventional cardiologists, anesthesiologists, nurse practitioners and other intensivists (healthcare personnel who specialize in intensive or critical care) are involved at every step. A partial list of procedures includes the following:
Combined interventional and surgical techniques (hybrid procedures) have been performed at Riley Hospital for Children at IU Health since 2004. All told, more than 500 pediatric heart catheterizations (diagnostic, interventional, biopsy and electrophysiologic) take place each year at Riley at IU Health—more than at any other facility in Indiana and the most in the region.
The Riley Heart Center provides a range of state-of-the-art services for the diagnosis and treatment of cardiac rhythm disorders. Annually, our team performs and interprets more than 6,000 EKGs, 450 24-hour, continuous EKG monitors, 200 event recorders and 60 radiofrequency catheter ablations (a procedure to correct heart rhythm) annually.
About 200 patients with various pacemakers and defibrillator devices receive treatment and follow up at Riley Heart Center. Guided by pediatric cardiologists specially trained in pediatric electrophysiology, clinicians ensure that patients receive the best and most current care for heart rhythm problems.
More than 350 cardiac exercise stress tests take place at the Riley Heart Center each year in a lab dedicated to the sophisticated evaluation of children and their responses to maximal exercise. Reasons for exercise stress tests vary from cardiac clearance for school sports to evaluations after fainting episodes, exercise-induced chest pain, abnormal heart rhythms, heart surgery or heart transplant.
State-of-the-art equipment used for exercise testing includes treadmills and bicycles with computer-controlled workload adjustments, measurement of peak oxygen consumption, blood oxygen saturation, continuous heart rate and rhythm, blood pressure, and other respiratory and metabolic parameters. Our cardiology team uses an exercise physiologist to coordinate exercise stress tests, provide individualized exercise programs for patients and assist in exercise-related research.
Adult Congenital Heart Disease Program
For the past half century, children with congenital heart defects have been diagnosed and treated more successfully leading to better long-term results. As a result, the number of adults with congenital heart defects in the United States is rising. At least half of these adults have conditions that are complex enough to require ongoing follow-up and treatment by healthcare professionals with expertise in the care of these patients.
Meeting the unique and complex needs of this special population of patients is the mission of the Riley Heart Center Adult Congenital Heart Disease Program. This program was established in 1991 to provide multidisciplinary, continuing care for adolescents and adults with chronic congenital heart conditions. The service is jointly staffed by Riley Heart Center pediatric cardiologists and adult cardiologists from the Krannert Institute of Cardiology at the Indiana University School of Medicine.
This collaborative effort among leading physicians ensures our expertise in the wide range of cardiovascular problems facing these patients. Specially trained technicians, sonographers, and nurse clinicians complete the team and provide the breadth of services necessary for optimal healthcare. Other subspecialty services such as hematology, pulmonology, psychology, neurology and obstetrics are readily available.
Preventive Pediatric Cardiology Program
The Preventive Pediatric Cardiology Program aims to identify and manage risk factors in children that contribute to heart disease as adults. Modifying behaviors and medically managing high cholesterol and blood pressure during childhood will significantly decrease the chances of a heart attack or other cardiac-related concerns in the future. The Preventive Cardiology Program treats children with abnormal cholesterol and hypertension, primarily on an outpatient basis. During the course of treatment, patients and their families will meet with a multidisciplinary team, including a pediatric cardiologist, a dietitian, a nurse specially trained in blood pressure assessment and an exercise physiologist.