Specific knowledge of pediatric echocardiography to avoid pitfalls

Abstract

Echocardiography is often used to assess congenital heart diseases in children. Specific knowledge of pediatric echocardiography is essential to avoid pitfalls because the points of assessment differ from those in adult echocardiography. This review focuses on 1) indications for pediatric echocardiography, 2) assessment of pediatric echocardiography, and 3) echocardiographic findings that can lead to pitfalls. Cardiac murmur is a major indication for pediatric echocardiography. First, it is important to approach the examination assuming cardiac disease as the possible cause based on the nature and location of the murmur. Second, it is necessary to confirm the structure of the heart via sequential segmental analysis, especially in the initial echocardiography, because congenital heart disease is often assessed in children. The subcostal cross-sectional sweep view with an upside-down image is useful for assessing the structures of the heart and the connections between the cardiac segments in children. Third, this review provides typical examples of echocardiographic findings that are likely to be pitfalls in pediatric echocardiography. However, this review alone does not provide sufficient knowledge to avoid all pitfalls because there are many variations in pediatric echocardiography. Thus, the confirmation of each undefined echocardiographic finding by a pediatric cardiologist or experienced sonographer is critical for avoiding pitfalls in pediatric echocardiography.