Training basic echocardiography to pediatric residents: need of the hour

Abstract

Pediatricians often come across children with suspected cardiac problems in clinical practice. This can be an emergency condition like cardiac tamponade due to large pericardial effusion, cardiogenic shock due to severe systolic dysfunction in any child with myocarditis or this could be a relatively stable condition like congestive heart failure due to acute rheumatic fever. In the neonatal age group, this could be any cyanotic cardiac lesion like transposition of great arteries, duct dependent lesions like critical aortic stenosis or pulmonary stenosis, requiring early recognition of these structural lesions for further management. Confirmation of the diagnosis of such conditions requires imaging by echocardiography. The diagnosis might be delayed if the attending pediatrician is not trained in echocardiography. On the other hand, if the on-duty resident is trained in doing echocardiography, the underlying cardiac structural or functional abnormality can be revealed early or it can be ruled out. With the advent of technology in the last 2 decades, there has been a widespread availability of portable ultrasound machines for clinicians involved in emergency and ICU care. Though the contribution of bedside echocardiography in the diagnosis and management of children with cardiac disease is invaluable and it is considered as a stethoscope of future , there is a lack of echocardiography skill among general pediatricians. Training them about the basic echocardiography skills to recognize pediatric cardiac diseases would help in better management of such children.