BECAUSE of the multiplicity of diagnostic techniques in pediatric cardiology, numerous skilled individuals will be required to participate in the patient's workup and it is essential that these work together as a team. The patient's physician still maintains the all important role of obtaining an adequate history and physical examination and making the referral to the pediatric cardiologist and participating in the resultant decisions about management of the patient.
Some of the newer techniques over the past decade extensively use x-rays and radioisotopes in the diagnosis of heart disease in infants and children. Most important, however, one should be aware of minimum radiation dose when employing these techniques. Fluoroscopic examination should be reserved for evaluating specific problems and more reliance placed on conventional x-rays of the chest as well as other parameters such as the electrocardiogram. An image intensifying unit for fluoroscopy or during cardiac catheterization should be used whenever possible. Optimal exposure factors which reduce radiation to a minimum during cardiac catheterization and angiography should be employed as well as gonadal protection devices during study. Yearly checks on radiation output of equipment should be carried out. When isotopes are used for indicator dilution studies to determine shunts and cardiac output, rapidly excreted ones should be employed with low activity and short half-life.
Recent developments in the recording of the electrical events of the heart beat include a battery-operated miniaturized radio broadcasting system which permits the recording of the electrocardiogram signal without the use of wires. The sender is attached to the patient and the receiver can be located as far away as 1,500 feet.
- Copyright © 1964 by the American Academy of Pediatrics