Segmental approach to performing a standard pediatric echocardiogram

The field of pediatric cardiology is rich with abnormal anatomy, unique congenital malformations and unusual surgical corrections that can be challenging to adequately image. The comprehensive pediatric echocardiogram is uniquely different from our adult colleagues and requires a systematic segmental approach to evaluate a wide range of structural and congenital abnormalities. This segmental approach focuses on the cardiac segments and the structures that connect them. The pediatric echocardiogram must adequately and efficiently differentiate and establish the cardiac structures in multiple planes with color and Doppler confirmation. The protocol for image acquisition is the extension of this segmental approach and should be designed with the comfort of the patient in mind, as well as the need to acquire all the necessary information in a swift and reproducible fashion. As such, the sequence of the obtained images is not and should not be the focus, but rather the comprehensive acquisition of the salient data from each imaging window. Herein, we describe the protocol used enterprise wide at three institutional locations for the systematic assessment of cardiac structure and anatomy.