Taking your child to a paediatric cardiology appointment can feel worrying, especially if you are unsure what to expect. You may wonder whether your child will need any tests, if they will be uncomfortable, and when you will receive the results.
During the appointment, the cardiologist will review your child’s symptoms and medical and family history, examine them and decide whether any tests are appropriate. Many first-line tests, such as an ECG or echocardiogram, are non-invasive and usually well tolerated, but not every child needs them. Some children may also need blood tests or more specialised investigations involving sedation, general anaesthesia or a separate appointment.
Why Has Your Child Been Referred to Paediatric Cardiology?
Your child may be referred to a paediatric cardiologist for several reasons, and you should remember that a referral does not automatically mean there is a serious heart problem. Many children are referred because of a heart murmur, chest discomfort, palpitations, fainting, or other symptoms that need further assessment.
Your child may also be referred because of an abnormal ECG, a family history of heart disease or concerns about your baby’s feeding, breathing or growth. The appointment helps the cardiologist understand your child’s heart health and decide whether any tests or treatment are needed.
What Should You Do Before the Appointment?
Preparing in advance can help your child’s appointment run more smoothly and ensure you get the most from the consultation. Bringing the right information and noting any questions beforehand can help your healthcare team complete a thorough assessment.
Preparing for Your Child’s Appointment
| Preparation Step | What to Bring or Do | Why It Matters | Helpful Tip |
| Read the appointment letter | Check for any instructions before the visit | Ensures you follow any required preparation | Review it a few days before the appointment |
| Bring important documents | Medication list, previous test results and clinic letters | Gives the specialist relevant medical information | Keep documents together in one folder |
| Dress your child comfortably | Choose loose, comfortable clothing | Makes the examination easier and more comfortable | Avoid clothing that’s difficult to remove |
| Bring requested medicines | Only if the clinic has specifically asked | Helps the team review current treatment if needed | Check the appointment letter first |
| Prepare your questions | Write down any concerns or symptoms | Helps you remember everything during the consultation | Keep a list on your phone or notepad |
| Arrive prepared | Allow enough time before your appointment | Reduces stress and helps the visit run smoothly | Plan your journey in advance |
How Can You Prepare Your Child?
You can help prepare your child by explaining the appointment in simple, age-appropriate language and reassuring them about what to expect. You should be honest without giving unnecessary detail, and encourage older children to ask questions if they have any concerns.
Bringing a favourite toy, book, or comfort item can help your child feel more relaxed while waiting. If you stay calm and positive, you can also help your child feel more confident about the appointment.
If your child has sensory sensitivities, communication needs, a learning disability or significant anxiety about medical settings, contact the clinic before the appointment. The team may be able to discuss reasonable adjustments, additional preparation support or access to a quieter waiting area, although the options available will vary between services.
Clinical Tip
Before the appointment, write down when your child’s symptoms occur, how long they last, what your child was doing and how they recovered. Note any important family history, particularly inherited heart conditions, unexplained fainting or sudden death at a young age.
What Happens When You Arrive?
When you arrive, you will usually check in at reception before your child is seen by a nurse, healthcare assistant, cardiac physiologist or doctor. Depending on the clinic and the reason for referral, measurements or tests such as an ECG or echocardiogram may be completed before or after the consultation.
Allow extra time because tests, waiting periods and consultations can make the visit longer than a standard appointment. The team should explain which findings can be discussed that day and whether any results or additional investigations will follow later.
Your Child’s Initial Measurements
Before your child sees the cardiologist, the clinical team may check their height, weight, pulse, blood pressure and oxygen saturation. These non-invasive measurements provide useful information about your child’s general health and circulation, but they do not diagnose a heart condition by themselves.
The blood pressure cuff may briefly feel tight, and some children may become unsettled during the checks. The team regularly works with children and will help your child feel as comfortable as possible.
Discussing Your Child’s Symptoms
The cardiologist will ask about your child’s symptoms, including when they started, how often they occur, and what your child was doing at the time. You should describe the symptoms as clearly as possible, even if you are unsure whether they are related to your child’s heart.
You can help by explaining details about palpitations, chest pain, fainting or breathlessness, including how long the symptoms last and how your child recovers.
Questions About Feeding, Growth and Activity
The cardiologist may ask about your child’s feeding, growth and activity levels to assess whether symptoms are affecting their development or usual daily activities. You should mention if your baby has difficulty feeding or gaining weight, or if your older child becomes unusually tired or breathless during exercise.
You can help by describing any changes in your child’s usual activity levels and mentioning any advice previously given by a doctor or school.
Reviewing Medical and Family History
The cardiologist will ask about your child’s medical history, including previous illnesses, medicines, and any hospital treatments. You should also mention any recent infections or health conditions that could affect your child’s heart.
Your family history is also important, so tell the specialist about relatives with inherited heart conditions, cardiomyopathy, abnormal heart rhythms, unexplained fainting or sudden death at a young age. This information helps the cardiologist decide whether your child needs further tests or specialist follow-up.
When Should You Seek Urgent Medical Help?
Most paediatric cardiology referrals are managed through planned appointments, but you should not wait for a routine consultation if your child develops severe or rapidly worsening symptoms. Seek urgent advice from your GP, NHS 111 or your child’s specialist team if they experience repeated fainting, worsening palpitations, concerning breathlessness or a significant change in their usual condition.
Call 999 if your child is not breathing or has severe difficulty breathing, such as gasping, choking or being unable to speak normally. Also call 999 if they cannot be woken within one minute after fainting, have not fully recovered, have difficulty speaking or moving, faint during exercise or while lying down, or faint with chest pain or a pounding, fluttering or irregular heartbeat. Emergency help is also needed if they are shaking or jerking because of a suspected seizure or fit, or have seriously injured themselves.
Call 999 if your child’s lips, tongue, face or skin suddenly turn blue or grey. They may also have difficulty breathing, chest pain, confusion, drowsiness or dizziness, or appear unusually limp, floppy or unresponsive. If only your child’s fingers, toes, hands or feet appear blue or grey and they are otherwise responsive and breathing normally, contact NHS 111 for urgent advice.
The Physical Examination
The physical examination helps the cardiologist assess your child’s heart, circulation and overall health. These checks are gentle, painless and usually performed while you stay with your child.
- Heart sounds: The doctor listens for murmurs, extra heart sounds or abnormal rhythms.
- Pulse check: Pulses are assessed to evaluate blood flow and circulation.
- Breathing assessment: Breathing pattern and lung sounds are carefully examined.
- Skin colour: The doctor checks for blue or grey colouring that may suggest low oxygen levels or poor circulation. On brown or black skin, changes may be easier to see on the lips, gums, inside the eyelids, palms or soles.
- Overall assessment: The examination findings help determine whether further heart tests are needed.
The results of the examination, together with your child’s symptoms and medical history, help guide the next steps in diagnosis and care.
What Happens During an ECG?
An ECG records the electrical activity of your child’s heart and helps the cardiologist assess their heart rate and rhythm. During the test, small sticky electrodes are placed on your child’s chest, and sometimes their arms and legs, to record the heart’s natural electrical signals.
An ECG is quick and non-invasive and does not send electricity into your child’s body. Your child will need to remain still while the recording is taken, although removing the sticky electrodes may cause brief discomfort or mild skin irritation.
An ECG records only a short period of the heart’s electrical activity. It may identify an abnormal heart rhythm or another unusual electrical pattern, but intermittent symptoms may require longer monitoring, and an ECG does not provide the same structural information as an echocardiogram.
What Happens During an Echocardiogram?
An echocardiogram is an ultrasound scan that creates moving images of your child’s heart. It provides information about the heart’s structure, valve movement, pumping function and blood flow. Depending on the clinic, the scan may be performed by a trained cardiac physiologist, echocardiographer, sonographer or doctor.
A probe is moved across your child’s chest using ultrasound gel. The scan does not use ionising radiation and is generally painless, although some children may find the gel or pressure from the probe mildly uncomfortable. Your child will need to remain reasonably still so that clear images can be obtained.
Will Your Child Need Sedation for an Echocardiogram?
Most children can have an echocardiogram while they are awake. Sedation may occasionally be considered when a baby or young child cannot remain still enough for the team to obtain reliable images. The decision will depend on your child’s age, health, the type of scan and the facilities available.
If sedation is planned, the team will explain its purpose, possible risks and the instructions for food, drinks and medicines. Do not fast your child or change their medicines unless the hospital or cardiac team has specifically instructed you to do so.
UK Guidance Note
NICE guidance states that children undergoing sedation should receive an appropriate pre-sedation assessment, clear preparation instructions and monitoring by trained staff. Follow the instructions provided for your child and do not independently alter their food, drinks or medicines before the appointment.
Longer Heart-Rhythm Monitoring
A standard ECG records only a short period of heart activity. If symptoms occur intermittently, the cardiologist may recommend a portable monitor. A 24- to 72-hour monitor may be useful when symptoms happen frequently, while less frequent symptoms may require a longer event monitor. Your child may be asked to keep a diary of symptoms and activities.
Your child may be asked to continue their usual activities and keep a diary recording symptoms and what they were doing at the time. The type and duration of monitoring will depend on how frequently the symptoms occur, and you should follow the team’s instructions about bathing, swimming and exercise.
Exercise Testing
An exercise test shows how your child’s heart responds during physical activity and may be recommended if their symptoms occur during exercise. Whether the test is suitable will depend on your child’s age, size, ability to use the equipment and the reason for testing. Your child will usually walk on a treadmill or use an exercise bike while their ECG and heart rate are monitored; blood pressure, oxygen levels or breathing may also be assessed.
If an exercise test has been arranged, your child should wear comfortable clothing and suitable footwear and follow any instructions about food, drinks or medicines. Do not stop medication unless the cardiology team specifically advises you to do so.
The results may be discussed during the appointment or after the recording has been reviewed, depending on the service. The team will explain whether further assessment, follow-up or treatment is recommended.
Could Other Investigations Be Needed?
Some children may need additional investigations such as blood tests, a chest X-ray, ambulatory blood pressure monitoring, genetic testing, cardiac MRI or CT. In selected cases, the cardiologist may recommend a more specialised procedure such as cardiac catheterisation or an electrophysiology study. These investigations are not routine for every child and may require a separate appointment.
If another investigation is recommended, the cardiologist will explain why it is needed, how to prepare and when the results are likely to be available. They should also discuss sedation, general anaesthesia, contrast material or radiation where relevant. Needing further tests does not automatically mean your child has a serious heart condition.
When Will You Receive the Results?
Some findings from the examination, ECG or echocardiogram may be discussed during the same appointment. However, this depends on the clinic, the type of test and whether the findings require further review by the cardiology team.
Longer rhythm recordings, specialist imaging and blood or genetic tests generally require additional analysis. Before leaving, ask when the remaining results are expected, how they will be communicated and whom you should contact if you have not received them within the stated timeframe.
What May Happen After the Appointment?
After the appointment, your child may be discharged if the examination and test results are reassuring, or you may be offered a follow-up visit to monitor their progress. You should remember that follow-up appointments do not necessarily mean your child’s condition is serious or getting worse.
If a heart condition is diagnosed, the cardiologist will explain the findings and discuss the most appropriate treatment or monitoring plan. You should also ask whether your child can continue normal school activities and sports, and follow any individual advice provided by the cardiology team.
Key Takeaways
- A referral to paediatric cardiology does not automatically mean your child has a serious heart condition.
- The appointment usually includes a discussion of symptoms, medical and family history and a physical examination.
- Measurements or heart tests may be performed before or after the consultation, depending on the clinic.
- ECGs and echocardiograms are non-invasive and usually well tolerated, although mild discomfort is possible.
- Longer rhythm monitoring may be recommended when symptoms do not occur during a short ECG.
- Do not fast your child or change their medicines unless the clinical team has provided specific instructions.
- Ask when results will be available and whether your child needs any activity restrictions or follow-up.
- Call 999 if your child has severe breathing difficulty, suddenly develops blue or grey lips, tongue, face or skin, does not fully recover after fainting, or faints during exercise or while lying down.
Frequently Asked Questions
1. How long does a paediatric cardiology appointment usually take?
The appointment length varies between clinics and depends on whether your child needs measurements, an ECG, an echocardiogram or another test. Check the appointment letter and allow extra time for testing and waiting. Contact the clinic beforehand if you need a more specific estimate for travel, school or work arrangements.
2. Will my child need heart tests at their first appointment?
Not always. The paediatric cardiologist will first review your child’s symptoms, medical history and examination findings before deciding whether tests such as an ECG or echocardiogram are necessary. Some children only require a clinical assessment.
3. Are ECGs and echocardiograms painful for children?
ECGs and echocardiograms are non-invasive and usually well tolerated. Removing ECG electrodes may cause brief discomfort or mild skin irritation, while some children may dislike the ultrasound gel or pressure from the probe. Tell the team if your child is anxious or uncomfortable.
4. Can I stay with my child during the appointment and tests?
You can usually remain with your child during the consultation, examination and common non-invasive tests. However, local policies, space limitations or the type of procedure may occasionally affect this, so ask the clinical team if you are unsure.
5. Does my child need to fast before a paediatric cardiology appointment?
Most routine cardiology appointments, ECGs and echocardiograms do not require fasting. However, if sedation or a specialised procedure has been planned, your appointment letter will provide specific instructions to follow.
6. What should I bring to my child’s cardiology appointment?
Bring your appointment letter, a list of your child’s current medicines, any previous test results or clinic letters and details of any relevant family history of heart conditions. It can also be helpful to write down any questions you want to ask the cardiologist.
7. When will we receive the test results?
Some ECG and echocardiogram findings may be discussed during the appointment, but this depends on the service and whether further review is required. Longer rhythm monitoring, specialist scans and blood or genetic tests usually take additional time to analyse. Ask when and how each result will be communicated.
8. What happens if the cardiologist finds a heart problem?
If a heart condition is identified, the cardiologist will explain what has been found, whether further tests are needed and what happens next. Depending on the condition, the plan may involve reassurance, monitoring, medicine, a specialist procedure or surgery. Recommendations will be based on your child’s individual diagnosis and needs.
9. Does a heart murmur always mean my child has heart disease?
No. Innocent heart murmurs are common in children and are not caused by structural heart disease. A paediatric cardiology assessment can help determine whether the murmur has innocent characteristics or requires further investigation.
10. Can my child continue school and sports after the appointment?
Many children can continue their usual school and physical activities after assessment, but advice depends on their symptoms and findings. Ask the cardiologist whether your child needs any temporary restrictions, particularly if they have experienced fainting, chest discomfort or palpitations during exercise.
Final Thoughts: What to Expect from a Paediatric Cardiology Appointment
It is understandable to feel concerned when your child is referred to a heart specialist, but a referral does not automatically mean that a serious condition will be found. The appointment allows the team to review your child’s symptoms and history, examine them and arrange only the tests that are likely to provide useful information.
Bring your questions and relevant medical information, follow any preparation instructions and ask when the results will be available. Arranging an assessment with a paediatric cardiologist in London can help you understand the findings, whether follow-up is needed and what the next steps mean for your child’s care.
References:
- Newcastle upon Tyne Hospitals NHS Foundation Trust (2026) Children’s Cardiothoracic Outpatients (Clinic E). Available at: https://www.newcastle-hospitals.nhs.uk/services/cardiothoracic-services/childrens-heart-unit/childrens-cardiac-outpatients/
- University Hospitals Bristol and Weston NHS Foundation Trust (no date) Cardiology clinics. Available at: https://www.uhbristol.nhs.uk/patients-and-visitors/your-hospitals/bristol-royal-hospital-for-children/the-paediatric-cardiac-service/what-we-do/cardiology-clinics/
- NHS (2023) Electrocardiogram (ECG). Available at: https://www.nhs.uk/tests-and-treatments/electrocardiogram/
- NHS (2026) Echocardiogram. Available at: https://www.nhs.uk/tests-and-treatments/echocardiogram/
- University Hospital Southampton NHS Foundation Trust (no date) ‘Diagnosis and treatment (children’s cardiac)’. Available at: https://www.uhs.nhs.uk/for-visitors/southampton-childrens-hospital/childrens-services/childrens-cardiac/diagnosis-and-treatment
- Great Ormond Street Hospital for Children NHS Foundation Trust (no date) Cardiac screening tests. Available at: https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/inherited-cardiovascular-diseases/cardiac-screening-tests/
- National Institute for Health and Care Excellence (2010) Sedation in under 19s: using sedation for diagnostic and therapeutic procedures. Clinical guideline CG112. Available at: https://www.nice.org.uk/guidance/cg112
- NHS (2023) ‘Fainting’. Available at: https://www.nhs.uk/symptoms/fainting/
- NHS (2023) ‘Blue or grey skin or lips (cyanosis)’. Available at: https://www.nhs.uk/symptoms/blue-skin-or-lips-cyanosis/
- Steinberg, J.S. et al. (2017) ‘2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry’, Annals of Noninvasive Electrocardiology, 22(3), e12447. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6931745/
- Royal Brompton and Harefield hospitals (no date) ‘Innocent heart murmur in children’. Available at: https://www.rbht.nhs.uk/our-services/innocent-heart-murmur-children
- Great Ormond Street Hospital for Children NHS Foundation Trust (no date) ‘Your child is having an echocardiogram under sedation’. Available at: https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/your-child-having-echocardiogram-under-sedation/
- Royal Devon University Healthcare NHS Foundation Trust (2025) ‘Children’s exercise tolerance test’. Available at: https://www.royaldevon.nhs.uk/media/oqfhxskb/children-s-exercise-tolerance-test-rd-e-21-057-002.pdf
- Kingston and Richmond NHS Foundation Trust (2024) ‘Syncope (fainting) in children and young people’. Available at: https://www.kingstonandrichmond.nhs.uk/patients-and-families/patient-leaflets/syncope-fainting-children-and-young-people