We believe that the first time any newborn has an echocardiogram that it should not only assess function (e.g. PDA) but also rule out structural congenital heart disease.
It is unrealistic for neonatologists to achieve anything like the expertise which paediatric cardiologists have in diagnosing structural heart disease. However it can be argued that neonatologists performing echocardiograms merely need to recognise what is normal, and what is abnormal.
To define or exclude normality requires a number of views to be performed, and all views should be performed in all infants. In all cases it is essential to follow a structured approach to echocardiography. At every scan we would recommend that standard views are gained in sequence, with at least a minimum ‘checklist’ of normal anatomical features confirmed. The standard views for echocardiography are listed below, and example images and anatomical descriptions are given via the links on the right hand side. The echocardiogram should be performed in a logical sequence, taking care to delineate the venous drainage, all four cardiac chambers, the septae and all four valves. For this reason we suggest starting with the subcostal views, however others prefer to leave these views to last in case pressure on the abdomen disturbs the child.