CARDIAC SPECIALTIES
At Carolina Children’s Heart Specialists, our state of the art office offers a wide range of services with the most advanced cardiac technologies. Our highly trained staff is committed to diagnosing and treating cardiovascular disease to improve the quality of our patient’s and their family’s lives.
Our services include:
Murmur Evaluation
Heart murmurs are common in healthy infants, children, and adolescents. Although most are not pathologic, a murmur may be the sole manifestation of serious heart disease. Historical elements that suggest pathology include family history of sudden cardiac death or congenital heart disease, in utero exposure to certain medications or alcohol, maternal diabetes, history of rheumatic fever or Kawasaki disease, and certain genetic disorders.
Echocardiography provides a definitive diagnosis and is recommended for evaluation of any potentially pathologic murmur, and for evaluation of neonatal heart murmurs because these are more likely to be manifestations of structural heart disease.
Chest Pain
Many people with chest pain fear there is a heart problem. However, there are many possible causes of chest pain. Some causes are not dangerous to your health, while other causes are serious and, in some cases, lifethreatening. Any organ or tissue in your chest can be the source of pain, including your heart, lungs, esophagus, muscles, ribs, tendons, or nerves. Pain may also spread to the chest from the neck, abdomen, and back.
Palpitations
Heart palpitations are heartbeats that suddenly become more noticeable.
Your heart may feel like it’s pounding, fluttering or beating irregularly, often for just a few seconds or minutes. You may also feel these sensations in your throat or neck.
Palpitations may seem alarming, but in most cases they’re harmless and are not a sign of a problem with your heart.
EKG
An electrocardiogram (EKG) is painless and harmless. A nurse or technician will attach 12 soft, sticky patches called electrodes to the skin of your chest, arms, and legs. The patches are about the size of a quarter.
This helps detect your heart’s electrical activity from many areas at the same time.
After the patches are placed on your skin, you’ll lie still on a table while the patches detect your heart’s electrical signals. A machine will record these signals on graph paper or display them on a screen.
The entire test will take about 10 minutes.
Stress Test
A stress test, sometimes called a treadmill test or exercise test, helps your doctor find out how well your heart handles its workload. As your body works harder during the test, it requires more fuel and your heart has to pump more blood. The stress test can help determine the following:
- If you have an irregular heartbeat.
- If your symptoms (such as chest pain or difficulty
breathing) are related to your heart. - How hard you should exercise when you are joining
a cardiac rehabilitation program or starting an
exercise program. - If treatments you have received for heart disease are
working. - If you need other tests (such as a coronary
angiogram) to detect narrowed arteries.
Echocardiogram
An echocardiogram (echo) is a graphic outline of the heart’s movement. During an echo test, ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest provides pictures of the heart’s valves and chambers and helps the sonographer evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart’s valves.
An echocardiogram can determine the presence of many types of heart disease, such as valve disease, myocardial disease, pericardial disease, infective endocarditis, cardiac masses and congenital heart disease.
Congenital Heart Disease
Congenital (meaning present at birth) heart disease is a term used to describe a number of different conditions that affect the heart. These heart abnormalities are problems that occur as the baby’s heart is developing during pregnancy, before the baby is born. Congenital heart disease (CHD) affects 1 in 120 babies born in the United States, making heart defects the most common birth defects. Specific steps must take place in order for the heart to form correctly. Often, congenital heart disease is a result of one of these crucial steps not happening at the right time.
Hypertension
High blood pressure is defined as a systolic blood pressure at or above normal averages depending on age. Systolic blood pressure is the maximum pressure in the arteries when the heart contracts. Diastolic blood pressure is the minimum pressure in the arteries between the heart’s contractions. How hypertension impacts on your heart and blood vessels Hypertension is a risk factor for coronary heart disease and the single most important risk factor for stroke. It causes about 50% of ischaemic strokes and increases the risk of hemorrhagic stroke. Hypertension stresses your body’s blood vessels, causing them to clog or weaken. Hypertension can lead to atherosclerosis and narrowing of the blood vessels making them more likely to block from blood clots or bits of fatty material breaking off from the lining of the blood vessel wall. Damage to the arteries can also create weak places that rupture easily or thin spots that balloon out the artery wall resulting in an aneuvrism.
Syncope
Syncope is a sudden, brief loss of consciousness (LOC) with loss of postural tone followed by spontaneous revival. The patient is motionless and limp and usually has cool extremities, a weak pulse, and shallow breathing. Sometimes brief involuntary muscle jerks occur, resembling a seizure.
Most deficiencies in cerebral blood flow result from decreased cardiac output caused by cardiac disorders that obstruct outflow, cardiac disorders of systolic dysfunction, cardiac disorders of diastolic dysfunction, as well as arrhythmias (heart beat too fast, too slow, or irregularly).
Irregular Heartbeat
An abnormal heart rhythm is when your heart beats too fast, slow, or irregularly. This is also called an arrhythmia. Within the heart is a complex system of valves, nodes, and chambers that control how and when the blood is pumped. If the functions of this vital system are disrupted, damaged, or compromised, it can change the pattern with which your heart beats. Arrhythmias can cause no symptoms or you may feel discomfort, fluttering, pain, or pounding in your chest.
Not all arrhythmias are life threatening, but by scheduling an appointment, we can determine the cause and severity of your arrhythmia.
Pacemaker Placement and Management
The procedure to implant a pacemaker is usually quick. It does not require open-heart surgery, and most people go home within 24 hours. Before the surgery, medication is usually given to make you sleepy and comfortable. The procedure is usually performed under general anesthesia. A small incision, approximately 2 inches long will be made in the upper chest wall. One or two leads (thin insulated wires) will be guided through a vein into the heart. We then connect the lead(s) to your pacemaker and program the device for your medical needs. Then the pacemaker will be inserted beneath your skin, and the incision in your chest will be closed. After your procedure, we will test the pacemaker to ensure it is working properly to meet your medical needs.
ICD Placement and Management
An implantable cardioverter defibrillator (ICD) insertion of an electronic device just below the collarbone is used to help regulate potentially fast and life-threatening electrical problems with the heart. An ICD monitors the heart’s electrical activity using wires with electrodes on the end that are placed in specific areas of the heart. The ICD responds to irregular life-threatening heart rhythms from the lower chambers of the heart with either anti-tachycardia pacing (ATP) consisting of low energy impulses to promote a normal heartbeat, or shock therapy with high energy impulses, to prevent sudden cardiac arrest.
EP (electrophysiology) Study and Ablation for Complex Arrhythmias
Cardiac ablation is a procedure that can correct heart rhythm problems (arrhythmias). Ablation usually uses long, flexible tubes (catheters) inserted through a vein in your groin and threaded to your heart to correct structural problems in your heart that cause an arrhythmia. Cardiac ablation works by scarring or destroying tissue in your heart that triggers an abnormal heart rhythm. In some cases, ablation prevents abnormal electrical signals from traveling through your heart and, thus, stops the arrhythmia. Cardiac ablation is done using catheters, making the procedure less invasive and shortening recovery times.
Sudden Death Syndromes
Sudden death syndrome describes a sudden, unexpected death which may occur during sleep, while awake, or just after exercise. Most sudden deaths are due to a heart condition and are known as sudden arrhythmia death or sudden cardiac death syndrome. Sudden arrhythmia death is most commonly due to a serious abnormal change to the heart’s rhythm known as an arrhythmia, such as ventricular tachycardia. Sudden cardiac death describes a sudden death as a result of an un-resuscitated cardiac arrest or heart attack.
The majority of sudden deaths are due to inherited heart conditions. Screening family members where there has been a heart condition or a previous sudden death, including a sudden infant death (SIDS), could identify pre-existing conditions that may cause sudden death. Appropriate treatment could then prevent or reduce the risk of sudden death occurring.