Echocardiograms are expensive, time consuming and require a cooperative patient to perform properly. In addition, sound does not travel well through everyone, so that the pictures are not always clear. For these reasons, strong suspicion of a heart defect ought to be present and a knowledge of the limitations of the test should be present before it is done. These tend to be more routine measurements and frequently do not require the same resolution as the indication for the evaluation of structural defects. Sometimes the test is misused, as other tests are more appropriate or not even indicated.
Examples are for an innocent murmur , palpitations , chest pain , or fainting.
In these cases, an echocardiogram may help in assessing the anatomy or function of the heart, but does not in and of itself tell the patient that there is no cardiac cause for the problem. For instance, in chest pain, the echocardiogram does not have the resolution for diagnosing placque or narrowing of the coronary arteries. In palpitations, the echocardiogram does not necessarily diagnose and rhythm abnormalities which may or may not cause the symptoms. Although the techniques for obtaining pictures in an adolescent and adult are similar, the techniques in assessing for congenital heart defects versus acquired heart diseases in adults are quite different. Therefore, the pediatric echocardiogram is best interpreted by a physician well trained in the disease processes in infants, children and adolescents, and is usually a board certified pediatric cardiologist with special training in echocardiography.