An Echocardiogram (Pediatric)—often called a pediatric echo or child heart scan—is a specialized ultrasound test that creates moving pictures of a baby’s or child’s heart. It uses sound waves (not radiation) to show the heart’s chambers, valves, major blood vessels, and blood flow patterns in real time. Pediatric echocardiograms are typically performed and interpreted by clinicians trained in children’s heart conditions (pediatric cardiology) because the normal heart looks different at different ages and congenital (present-at-birth) differences are common reasons for testing.

This test helps your child’s care team evaluate:

• Heart structure: Whether the walls between chambers are intact, whether valves are formed normally, and whether major vessels are connected in the usual way.
• Heart function: How well the heart muscle squeezes and relaxes and whether the heart is pumping effectively.
• Blood flow: Using Doppler ultrasound, the test estimates the direction and speed of blood flow, which can reveal valve leakage (regurgitation), valve narrowing (stenosis), or abnormal connections/shunts.

What results can mean: A “normal” pediatric echocardiogram usually indicates that the heart’s anatomy and pumping function look appropriate for your child’s age and size. An “abnormal” result does not automatically mean a dangerous problem—many findings are mild or treatable. Abnormalities may suggest a congenital heart defect (such as a hole between chambers), a valve problem, elevated pressures in the heart or lungs, inflammation, infection-related changes, or reduced heart muscle function. Your clinician will interpret results in context with symptoms, physical exam findings (such as a murmur), and other tests (like an ECG or chest X-ray).

Doctors commonly order a pediatric echocardiogram when they need a clear, noninvasive look at a child’s heart or when there is concern for a congenital or acquired heart condition. It may be performed in newborns, infants, children, and teenagers, and it can be done urgently in the hospital or as a scheduled outpatient test.

Common reasons your child may need this test include:

• Heart murmur: To determine whether a murmur is “innocent” (harmless) or related to a structural issue such as a valve problem or a congenital heart defect.
• Symptoms suggesting a heart problem: Fast breathing, trouble feeding in infants, poor weight gain, excessive sweating with feeds, bluish color of lips/skin (cyanosis), chest pain with exertion, dizziness or fainting (syncope), unexplained fatigue, or exercise intolerance.
• Abnormal screening tests: Concerning findings on pulse oximetry screening in newborns, an abnormal electrocardiogram (ECG/EKG), or chest X-ray findings suggesting an enlarged heart or increased lung blood flow.
• Known or suspected congenital heart disease: To diagnose a suspected defect, define anatomy before treatment, or monitor after surgery/catheter procedures.
• Family history or genetic risk: A close family member with congenital heart disease, or a genetic condition associated with heart differences (your clinician may recommend an echo even before symptoms appear).
• Conditions that can affect the heart over time: High blood pressure (including kidney-related causes), certain autoimmune/inflammatory conditions, suspected myocarditis, or monitoring effects of some medications that can impact heart function.
• Evaluation of heart infections or inflammation: Concerns for endocarditis (infection of heart valves) or pericardial effusion (fluid around the heart).

Because it is safe and painless, a pediatric echo is an important first-line tool to evaluate many childhood heart concerns and to guide next steps, which may include observation, medication, referral to a pediatric cardiologist, or planning for procedures when needed.

• Congenital heart defects (CHD), including atrial septal defect (ASD) and ventricular septal defect (VSD)
• Patent ductus arteriosus (PDA)
• Tetralogy of Fallot and other cyanotic congenital heart disease
• Coarctation of the aorta
• Aortic stenosis or pulmonary stenosis (narrowed heart valves)
• Mitral or tricuspid valve regurgitation (leaky valves)
• Cardiomyopathy (e.g., dilated or hypertrophic cardiomyopathy)
• Myocarditis (inflammation of the heart muscle)
• Pericardial effusion/pericarditis (fluid or inflammation around the heart)
• Pulmonary hypertension (high blood pressure in the lungs’ blood vessels)
• Endocarditis (infection of the heart lining/valves)

• Diagnosing or ruling out a congenital heart defect in infants and children
• Clarifying the cause of a heart murmur or abnormal heart sounds
• Monitoring heart growth and development over time in children with known heart conditions
• Assessing heart pumping function and valve performance to guide treatment decisions
• Evaluating symptoms like shortness of breath, poor feeding, low stamina, chest pain, or fainting
• Checking recovery and long-term outcomes after heart surgery or catheter-based repair
• Screening or follow-up when a family history or genetic condition increases heart risk
• Supporting safe participation in sports/physical activity when cardiac concerns are present