Pediyatrik Kalp Hastaliklarında Tanı Yöntemleri
Synopsis
The diagnostic process in pediatric cardiology begins with a detailed patient history, physical examination, chest radiography, pulse oximetry, and blood pressure measurements. While pregnancy, birth, medication, and family history are thoroughly questioned during history taking, physical examination evaluates cyanosis, murmurs, peripheral pulses, precordium, organomegaly, and rashes. Chest radiography provides basic information regarding cardiothoracic ratio, cardiac contour, and pulmonary vascularity, whereas pulse oximetry is a mandatory criterion for screening critical cyanotic congenital heart diseases in the early neonatal period. Inter-extremity blood pressure measurement is used to detect coarctation of the aorta, while 24-hour ambulatory blood pressure monitoring is utilized to identify white coat hypertension and nocturnal blood pressure load. Electrocardiography (ECG), 24-hour Holter ECG, event recorders, and invasive electrophysiological studies play a critical role in diagnosing rhythm and conduction disorders. Echocardiography (TTE, TEE, Fetal, and Stress Echo) serves as the primary non-invasive imaging modality to evaluate cardiac chambers, valves, cardiac shunts, and functions. Exercise testing is preferred for evaluating ischemia and exercise capacity, whereas the tilt table test is chosen to evaluate vasovagal syncope. Computed tomography and magnetic resonance imaging depict complex anatomical and vascular anomalies radiation-free or with high resolution, while cardiac catheterization and angiography provide detailed hemodynamic data and interventional treatment options. Additionally, specific biochemical markers such as troponin, NT-proBNP, and CRP complement the diagnostic and follow-up processes.
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