Tests to Diagnose Your Child's Heart Disease

To learn your child's heart function, doctors at the Heart Institute at UPMC Children's Hospital of Pittsburgh may order the following tests.

Blood Count

The blood count is a test that tells us the type and number of blood cells present.

Certain heart problems may cause the blood count to be abnormal.

We'll draw blood from your child's vein or by pricking their finger or heel. You may stay with your child while we draw blood.

Chest X-ray

A chest x-ray is a picture that shows the size and shape of the heart, lungs, and major blood vessels. The amount of radiation we use is very small and isn't harmful.

If your child is old enough to comply, we'll ask them to hold their breath and be still for two to three seconds while we take the picture.

We ask that you wait in a nearby room while we take the x-ray. An x-ray tech will stay with your child and provide any special help they might need.

Dobutamine Stress Echocardiogram (DSE)

The DSE is useful in diagnosing coronary artery disease (blockage in the arteries that supply blood to the heart muscle).

Dobutamine is a potent medicine that causes the heart to pump faster and harder.

We'll do an echocardiogram while your child is resting and again while we slowly inject dobutamine into a vein.

Normally, all areas of the heart muscle pump more vigorously when we give this medicine. If we don't see this vigorous pumping on the ECHO, it may mean a blocked or narrow coronary artery.

Echocardiogram (ECHO)

An ECHO makes a moving picture of your child's heart by using high-frequency (ultrasound) sound waves. It shows the picture of the beating heart on a TV screen. It can also show the direction of the blood flow through the heart.

Your child needs to lie quietly on the exam table during the test. Young children who are restless may need sedation by mouth.

We place three small stick-on patches (electrodes) on your child's chest.

Then, we cover a small sound wave wand with a jelly substance and move it slowly over the chest.

The wand may make noises and your child may feel slight pressure as we move it over the chest. But an ECHO test doesn't hurt.

To improve the quality of the picture on the screen, we do the ECHO in a dimly lit room.

The length of time we need to complete the ECHO varies greatly. It may last from 30 to 60 minutes. We'll try to complete the test as quickly and carefully as we can.

You can stay with your child during the test. We also have videos your child can watch.

We record some parts of the test on paper and others on video.

The results of the ECHO give your child's heart doctor valuable data about the heart's structure and function. In some cases, it can provide enough accurate data that your child won't need a heart cath.


The heart has a special electrical system that allows it to beat.

An EKG records the work of this system on graph paper, including the:

  • Rhythm of the heartbeat.
  • Size of the chambers of the heart.
  • Amount of blood going to the heart muscle itself.

An EKG is a painless test and takes only a few minutes.

To get the most precise EKG, your child will need to lie quietly on the exam table.

To get the reading, we place small sensors (electrodes) on your child's wrists, ankles, and chest.

If your child is anxious, you can hold their hand or talk with them.

Exercise (Stress) Test

An exercise stress test tells us how the heart works and adjusts to different levels of activity.

To prep for the stress test, your child should eat a light meal two hours before coming to the hospital. They should wear comfortable clothing and shoes.

We do the test in a special room equipped with EKG and blood pressure monitoring equipment.

Your child will walk or run on a treadmill as long as they can.

After the test, they may feel tired. The doctor and tech will check your child's vitals and observe them for several minutes after the test.

Most kids feel rested after this brief time.

After the test, your child can eat, drink, and resume normal activities, including returning to school.

Fetal Echocardiogram

A fetal ECHO looks at the heart function of a baby before birth.

We move the transducer slowly over the expectant mother's belly.

Women can have this test any time after the 18th week of pregnancy.

Heart Catheterization (Heart Cath)

A heart cath is a minimally invasive procedure that lets doctors look at and gather data from inside the heart.

Doctors place thin, flexible tubes — called catheters — into the big blood vessels in the groin to get inside the heart.

Heart Event Recorder (CardioBeeper)

The CardioBeeperTM is a small device that records problems with the heart's rate or rhythm. It's the size of a cigarette pack.

You'll use the event recorder at home for one month.

When your child feels their heart is beating strangely, you place the device on the chest for 30 seconds. It records the EKG pattern then sends it to the doctor by phone.

Holter Monitor

This portable device records an EKG for 24 hours. Your child wears it at home or school and during sleep.

The Holter monitor measures your child's heart rate and rhythm during their normal routine.

While your child is wearing the device, it's crucial to write down any symptoms, changes of activity, or other unusual events.


This test measures the amount of blood the heart pumps out to the body with each beat. We call the percent of the amount an ejection fraction.

For the MUGA scan, we'll give your child two shots of medicine. Your child will feel a pinch when we give them the shots. The rest of the scan isn't painful.

Your child will need to lie still on the exam table while a special machine (scanner) makes the necessary measurements. Smaller children may need sedation to remain still during the test.

The scanner looks like a large x-ray camera.

Sometimes, we'll order an exercise MUGA scan. We'll take the same measurements as the standard scan while your child exercises with special equipment.

You can stay with your child during a MUGA scan.


Nuclear magnetic resonance imaging (NMR or MRI) takes pictures (scans) of the inside of the body without using x-rays. Instead. it uses magnetic waves and a computer to make the picture.

MRI scans help us learn more about the heart structure.

We perform the scan in a room with a large doughnut-shaped machine. We'll place your child on a flatbed and then move it to the center of the machine. The test doesn't hurt, but the machine makes noises while it's working.

Your child will need to lie still during the scan. Young children may need sedation.

The scan lasts anywhere between 30 and 60 minutes.

We ask parents to wait in a nearby room. A member of the care team will be with your child to explain the procedure and offer comfort.

Transesophageal Echocardiogram (TEE)

We will sedate your child for this type of ECHO.

During TEE, we pass a small transducer into the mouth and down the esophagus (the tube that connects the mouth and stomach). The TEE shows the heart and surrounding blood vessels in greater detail than the standard ECHO.

Ventilation/Quantitative Perfusion Scan (V/Q Scan)

This test has two parts.

  1. Your child breathes a special gas. We take a scan to see which areas of the lungs fill with the gas.
  2. We inject a substance into your child's vein that we trace as it goes to the small vessels of the lungs. This defines where the lungs receive blood.