Chest XRay

Coeur-ensabot(bootshaped heart)

Preparation
A chest X-ray doesn't require
special preparation.
The child may be asked to remove
all clothing and jewelry from the
waist up and change into a
hospital gown because buttons,
zippers, clasps, or jewelry might
interfere with the image.
Developing babies are more
sensitive to radiation and are at
more risk for harm

Procedure
Parents are usually able to accompany their child to provide
reassurance and support.
infants may require gentle restraint. Keeping the chest still is
important to prevent blurring of the X-ray image. Two X-rays
are usually taken, one from the back and one from the side.
A chest X-ray may be performed in a standing, sitting, or lying
position.

Complete Blood
Common blood test
that evaluates the three
Count
major types of cells in the blood: red blood
cells, white blood cells, and platelets.
Results:
RBC = 10 MILLION/l (Normal: 3,700,000
5,300,000)
Hemoglobin = 18 g/dl (Normal 10.5 13.5
g/dl)
Hematocrit = 70% (Normal: 33-49%)
Platelet = 280,000/l (Normal: 150,000
450,000)
WBC = 12,000/l (Normal: 6000 17000)

RBC = 10 MILLION/l (Normal: 3,700,000

5,300,000)
A high red blood cell count is an increase in oxygencarrying cells in the bloodstream. Red blood cells
transport oxygen from lungs to tissues throughout our
body. A high red blood cell count can result from a
condition that limits your oxygen supply or a condition
that directly increases red blood cell production.

A high RBC count could be due to a number of health

conditions or health-related factors including:
CONGENITAL HEART DISEASE
dehydration for example, from severediarrhea
low blood oxygen levels (hypoxia)
pulmonary fibrosis a lung condition that causes scarring

Hemoglobin = 18g/dl (10.5 13.5 g/dl)

A high hemoglobin count indicates an above-normal level
of hemoglobin in the blood. Hemoglobin (often
abbreviated as Hb or Hgb) is the oxygen-carrying
component of red blood cells.
A high hemoglobin count is somewhat different from a
high red blood cell count, because each cell may not have
the same amount of hemoglobin proteins. Therefore, you
could have a high hemoglobin count even if your red
blood cell count falls within the normal range.
Causes:
Red blood cell production increases to compensate for
chronically low blood oxygen levels due to poor heart or
lung function
Specific disorders such as Congenital Heart Disease

Hematocrit = 70% (Normal: 33-49%)

Hematocrit is a blood test that measures how much of
a person's blood is made up of red blood cells. This
measurement depends on
the number of and size of the red blood cells.
The hematocrit blood test determines the percentage
of red blood cells (RBC's) in the blood
Causes of a high hematocrit include:
Dehydration(heat exhaustion, no available source of
fluids)
Low availability of oxygen (smoking, high altitude,
pulmonary fibrosis)
GENETIC (CONGENITAL HEART DISEASES)
Erythrocytosis (over-production of red blood cells by
the bone marrow or polycythemia vera)

Procedure
In young infants, the nurse will typically sterilize the
heel of the foot and use a small needle called a
lancet to prick the area. The nurse will then gently
squeeze the heel and collect a small amount of
blood in a vial for testing.

Echocardiography

Echocardiography is also known as Echo, Cardiac

Ultrasound, Doppler ultrasound of the heart, Cardiac
Ultrasonography, 2D echo test and 3d echo test. It is
a test that used to give an image of the heart using
sound waves. It can be used in conjunction with a
stress test to show the heart as it beats while the
patient is exercising.
Echocardiography is a very precise method to detect
the hearts movement and shape. It is a non-invasive

2D echo ejection fraction 30% (50 to 75

percent)

However, some patients have a very low EF

(less or equal to 30) and yet have minimal or
even no symptoms. Other signs of heart failure
may also accompany a low EF. These include:
An abnormal heart murmur (due to a heart
valve disorder)
A crackling sound of fluid in the lungs due to
pulmonary congestion
A rapid heartbeat or other abnormal heart
rhythms
Hypertrophy or enlargement of the heart
Liver or kidney malfunction
Congestion of the lungs
Swollen neck
Fluid retention with accompanying weight

Preparation:
Clothing should be removed from the waist up.
The patient is on a supine position for some infants
may be able to lie in their parents lap.
Electrodes will then be placed on the patients
body. A gel is applied to the chest followed by a
transducer i.e. a machine that sends and receives
sound which is placed on the body over the heart
and measures distance to produce the visual
representation of the heart on a monitor.
Most children do not need to do anything special to
get ready for an echocardiogram. However, if the
child is under three years old, he may need a
sedative. An echocardiogram works best when the
child does not move.
If the child is not sedated give them their favorite
toy, a security blanket, or a favorite videotape.

Pulse oximeter reading = 75% (Normal:

95 100%)
Pulse oximetry in clinical practice has allowed for simple, noninvasive,
and reasonably accurate estimation of arterial oxygen saturation.
How it measures oxygen saturation: The calculation of the
percentage of arterial oxyhemoglobin is based on the distinct
characteristics of light absorption in the red and infrared spectra by
oxygenated versus deoxygenated hemoglobin and takes advantage of
the variation in light absorption caused by the pulsatility of arterial
blood.

Electrocardiography
Measures the electrical activity of the heart and records
it on graph paper in the ECG. This allows the evaluation
of the sequence and magnitude of the electrical
impulses generated by the heart.
The standard pediatric ECG is measured using 15 leads,
with leads added on the right side of the chest and on
the left lateral chest area.

Cardiac Catheterization
Most invasive diagnostic procedure, in which radiopaque
catheter is inserted through a peripheral blood vessel into the
heart. It is usually combined with angiography, in which a
radiopaque contrast material is injected through the catheter
and into the circulation. Cardiac catheterization provides
information regarding the following:
Oxygen saturation of blood within the chambers and great
vessels
Pressure change
Cardiac output or stroke volume
Anatomic abnormalities