As one of the largest pediatric health systems in the United States, Nemours Children's Health System has made a promise to do whatever it takes to prevent and treat childhood illnesses and injury, from the most common to the most complex. Every day at Nemours, some of the country's top pediatric specialists, researchers and educators work together with our patients, their families, our physician partners, schools and communities to fulfill that promise.
Established in 1936 as a legacy of American industrialist and philanthropist Alfred I. duPont, Nemours cares for more than a quarter of a million children annually at its operations in Delaware, Pennsylvania, New Jersey, Maryland and Florida, treating children from across the nation and around the world. At Nemours, we are dedicated to achieving the highest standards and best outcomes for the children we serve. We begin by caring for children as if they were our own. For more than 70 years, this has been the Nemours way: the promise to care for every child as if they were our own.
The Nemours Children's Health System has two free standing children's hospitals: Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware and Nemours Children's Hospital in Orlando, Florida as well as a network of satellite locations. Nemours provides exceptional primary and sub-specialized pediatric care to over 250,000 children annually and is a leader in pediatric education and research with more than a 1000 residents, fellows and medical students training at Nemours sites. The Nemours KidsHealth.org is the worlds most visited website devoted to children's health and helps educate parents and children about common medical conditions. Nemours is ranked #14 in the United States for National Institute of Health research funding among free standing children's hospitals. Nemours Research Centers for Excellence have more than 300 active research projects and clinical trials.
Cardiovascular disease is a leading cause of morbidity and mortality in the United States and around the world. Cardiac disease can be present as a fetus and persist through all the stages of development from infancy to adulthood. Congenital heart defects are the #1 cause of birth defects and affect approximately 1 in 100 children. Nemours has built world class Cardiac Centers at both free-standing children's hospitals to care for these children from birth to adulthood. Nemours Cardiac Centers each have dedicated surgical suites, interventional/electrophysiology labs, cardiac intensive care units, non-invasive imaging, exercise physiology labs and are united via a common electronic medical record and imaging system as an enterprise. Our sites each have dedicated cardiac surgeons, anesthesiologists, intensivists, interventional cardiologists, electrophysiologists, pediatric cardiologists, cardiac genetics, psychologists, nurse practitioners and nurses committed to providing exceptional cardiac care for all of the children within their state. The clinical services offered include:
-
•
Cardiac surgery
-
•
Cardiac anesthesia
-
•
Interventional cardiology
-
•
Electrophysiology
-
•
Heart failure/transplant
-
•
Perinatal cardiology/fetal echocardiography
-
•
Non-invasive imaging (ECHO, MRI, CT)
-
•
Cardiovascular genetics
-
•
Preventative cardiology
-
•
Adult congenital heart disease
-
•
Psychology/neurodevelopmental
Echocardiography is the primary non-invasive tool for assessing cardiac structure and function and can image from fetus to adulthood. In children and adults, echocardiography is the primary tool for screening, diagnosing, and the longitudinal management of congenital heart disease and other forms of cardiovascular disease. Nemours Children's Health System performs >25,000 pediatric echocardiograms annually. Nemours is dedicated to enhancing the education of physicians, fellows, residents, medical students, sonographers and ancillary health providers in cardiovascular disease.
This supplemental edition of Progress in Pediatric Cardiology delivers multiple excellent review articles focusing on the role of echocardiography in diagnosis and management. We begin with the segmental approach to performing a pediatric echocardiogram, and then provide reviews of key topics with a focus on echocardiographic imaging. These key topics include reviews of transthoracic, transesophageal, and fetal echocardiography and their roles in specific departments within a heart center (clinic, operating room, cardiac catheterization lab and exercise physiology lab). Additional discussion on the role of echocardiography in common forms of congenital heart disease (septal defects) and high risk populations for sudden cardiac arrest (coronary anomalies and Williams syndrome) are presented, including the role of advanced non-invasive cardiac imaging (magnetic resonance imaging/computed tomography). Special highlights are provided on the modifications fetal echocardiography labs have made during the coronavirus pandemic and the role of echocardiography in multi-system inflammatory syndrome. Finally, interesting case studies presented by current trainees highlight the critical role of cardiac imaging in the diagnosis and management of pediatric heart disease. Special thanks to Dr. Peace Madueme and Mr. Daniel Biggers for their assistance with the echocardiographic images and illustrations displayed in the articles.
We hope this supplemental edition provides a solid foundation and understanding of the use of echocardiography and other cardiac imaging modalities used in the care of children with cardiovascular disease.