Most children we treat will not need invasive interventions or
surgery to manage their heart conditions and will be monitored in
cardiology clinics, where they will have regular contact with
our paediatric cardiologists and specialist nursing staff. The
staff will monitor their condition, check their treatments and
advise on the lifestyle choices best suited to them.
If your child does need surgery or cardiac catherisation your
cardiologist will talk to you about this in clinic. Please see the
links below for more information.
Planning for surgery? Click here for more information.
Planning for cardiac catheterisation? Click here for
more information.
Why do I have to come to clinic?
If your child is a new patient, their GP or another
hospital consultant may have referred them to assess their
heart. Usually the first clinic they attend will allow a
cardiologist to make a diagnosis and consider what treatment, if
any, is best for the child. A series of tests will be carried out
by cardiac physiologists /assistant technical officers to provide
information for the cardiologist's diagnosis. The clinics
provide the opportunity for you to meet with your child's
clinicians ask any questions you may have about your child's
condition and treatments and discuss any particular issues or
worries arising from your child's condition.
Existing patients are reviewed regularly to make sure their
cardiac condition is well managed and they are receiving the right
levels of treatment and care. If you are not sure why your
child has been sent a cardiology appointment, please discuss the
referral with your child's GP or current consultant.
What will happen in a routine cardiology clinic?
Your child will initially be seen by
the outpatient nurse who will record their weight,
height, blood pressure and oxygen saturations. They will then
be assessed by the consultant or a specialist trainee, who will
decide whether any further investigations such as a chest
X-ray or cardiac physiology tests such as echocardiogram or an
electrocardiogram (ECG) are performed by a cardiac
physiologist.
How do these work?
A variety of tests will be performed to get a clear picture of
what is causing the symptoms.
- An electrocardiogram (ECG) is a simple test where sticky
patches called electrodes are put on the patient's arms, legs and
chest. These are connected by wires to an ECG recording machine
that picks up the electrical signals that make your heart beat.
This electrical activity is recorded and printed onto paper.
This test helps inform your cardiologist about the electrical
function of your heart.
- Echocardiography is similar to the ultrasound scan
that a mother has whilst pregnant. An echocardiogram shows the
heart structures in considerable detail. This enables the clinician
to determine what is present and the appropriate
treatment.
- Pacemaker check - if your child has a pacemaker, you may be
seen in a specialist pacemaker clinic. The pacemaker will be
checked by senior cardiac physiologists and other tests will be
carried out if deemed necessary by the consultant present.
- Sometimes a child may be sent for a chest X-ray, particularly
if they have undergone any recent cardiac surgery.
There are a number of other tests that a clinician may ask to be
carried out, at a later date. These can include:
- Exercise Test - where the child is monitored whilst exercising
on a treadmill.
- Ambulatory event monitoring - when a child has a portable
monitor that will record infrequent events over a period of time.
These monitors will be worn whilst the child is in a normal home
environment. The tape will be returned to the hospital and
analysed.
- Virtual pacemaker clinic - if your child has a pacemaker you
may be given a monitor to take home with you, which you can use to
send us downloads of the pacemaker activity without the need for a
hospital visit. If this is possible, a cardiac physiologist will
discuss this with you soon after the
implant.
How long will it take?
This will depend on the number of tests your child may
need. An ECG will take approximately 15 minutes, and an
echocardiogram approximately 20 minutes or longer. An
exercise test takes about 40 minutes. Including the time
taken to see the consultant and the nursing team you should allow
at least two and a half hours to be seen.
If you are returning to the hospital at a later date, you will
probably not see the consultant. The appointment will be to see a
physiologist to have a test performed and therefore should not take
as long.
We do try to consolidate as many tests into the same appointment
as possible to reduce hospital visits. Sometimes this may not be
possible, but please contact us if you have any problems coming to
the hospital.
Who will I meet?
You will meet the outpatients' nurses and the cardiac
physiologist, who will do the ECG and echocardiogram.
You will also meet our radiology team if a chest X-ray is
required. A consultant will always be present at the clinic
although you may be seen by one of the specialist trainees.
This is a teaching hospital where we train doctors to become
consultant cardiologists. Your child will be
discussed with the consultant during your consultation, and they
will be available for you to talk to if you have further questions
or concerns about your child.
What if my child is anxious or worried about tests?
Staff in the Children's Hospital are used to helping children
overcome their anxiety so we will do our best to allay any anxiety
through play. A TV programme or DVD for distraction may
help and we have the assistance of a play specialist when
necessary. Occasionally a small amount of sedation may be
used, which would usually require a short stay admission to the
ward, but this is unusual. Parents are present whilst non-invasive
tests are carried out such as ECG's and echocardiograms.
Will I get the test results straight away?
Yes, your consultant will discuss the results of any tests
during your visit. Occasionally it is necessary to share the
results with colleagues within the team to agree a treatment
plan. However, if you come back for a test with a physiologist,
they will be unable to give any diagnoses without the consultant
seeing the test first.
What if I have more questions when I get home?
You can contact your cardiac nurse specialist who will be able
to find the answers for you, or you can speak to your child's GP
who may be able to help with more general queries.
What if I am worried about my child between appointments?
You should consult your GP in the first instance if you think
your child is unwell. If you have general concerns, for
instance questions regarding any restriction on lifestyle choices,
our cardiac nurse specialist team will be able to answer
many of these issues.
Do I have to come to Bristol if I don't live there?
We have outreach clinics throughout the south-west and most
patients are seen locally by a visiting consultant from
Bristol. Clinics are carried out at Truro, Plymouth,
Torbay, Exeter, Barnstaple, Taunton, Cheltenham, Gloucester, Bath
and Swindon. These are attended at least once a month by specialist
paediatric cardiologists from the unit.
Who will support me in the community?
If your child is diagnosed as a baby, your midwife will continue
to support you until your child is 8 weeks of age and will then
transfer you to your health visitor or GP. Older patients are
supported by their local GP and sometimes a local hospital team if
they live outside Bristol.
The cardiac nurse specialist team is available for additional
support and advice and can be contacted on 0117 342 8286 or 0117
342 8578 (Mon-Fri 8 a.m.- 4 p.m.) For non-urgent queries you
can contact your consultant's secretary: see our Meet the Team
section for contact details.
There are a number of external support organisations that you
may also find helpful. These are detailed in our Patient and Family
Information section, together with a range of patient
information leaflets and other useful resources.
