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Evelina London Children’s Hospital, ranked as one of the world’s best children’s hospitals by US Newsweek, is home to our world-leading fetal cardiology service and dedicated children’s cardiology unit.
Dr Owen Miller, consultant in paediatric and fetal cardiology, shares more about our department’s expertise and one-stop investigation service to streamline the diagnostic journey for children and their families.
Paediatric cardiology expertise at Evelina London
With a long history of innovation and world-firsts, the cardiology unit at Evelina London features the latest imaging technology, enabling us to provide life-changing care to thousands of children.
In addition to advance ultrasound techniques, we’re proud to offer a unique fetal cardiac MRI programme. With the first and largest fetal cardiology service in the UK, what truly sets Evelina London apart is our cardiac imaging expertise.
Dr Miller and the private paediatric cardiology team see several hundred patients each year on both an inpatient and outpatient basis. Our children’s cardiology specialists cover numerous areas of expertise, from the fetus to the adult and across both congenital and acquired heart disease, including heart rhythm abnormalities.
Dr Miller leads the certification programme for the European Association of Cardiovascular Imaging and Association of European Paediatric Cardiologists, focusing on echocardiographic imaging in congenital heart disease. He leads tutorials across a number of areas including echocardiography, multimodality imaging, and imaging for long-term complications.
“Our children’s cardiac MRI service has been established for decades,” says Dr Miller. To further develop this clinical excellence, our imaging specialists and clinical academics collaborate within King’s College London (KCL), carrying out world-leading research, to the benefit of all patients at Evelina London.
Advanced rapid response cardiac imaging
To improve detection of congenital heart disease during routine pregnancy scans, our specialists and researchers, working with imaging scientists at KCL, are developing a machine learning approach to improve the accuracy and efficiency of these scans.
A computer network processes thousands of ultrasound images, with the algorithm learning differences between images, helping the network to automatically identify anomalies in fetal hearts. Such advances may improve efficiency and accuracy of fetal diagnoses, working closely with established techniques and clinical teams to offer a rapid response diagnostic service to expecting parents.
A 3D MRI scan of a fetal heart
In addition to our pioneering 3D fetal cardiac MRI service, our specialists and researchers are also working on VR imaging to further improve accuracy in diagnostics and treatment for our young patients. “Our whole cardiology group is very strong in cardiac imaging,” explains Dr Miller. “Advances in the world of cardiac imaging can shorten patient waiting times and reduce the need for multiple surgeries, resulting in better outcomes for patients and their families.”
Innovative virtual reality technology at Evelina London brings together multiple scans to build 3D digital images of the heart. These images provide a clear view of each patient’s individual characteristics of the heart, and also allow our specialists to manipulate the images and trial options in virtual reality before performing the actual surgery.
One-stop cardiology diagnostic service
We know how stressful an undiagnosed cardiac issue can be for both our young patients and their parents. This is why our paediatric cardiologists offer a streamlined diagnostic process with the aim of examining the child, carrying out initial tests and interpreting results, providing a diagnosis and counselling the parents, usually all within a single appointment.
Our cardiologists can offer tests including:
- echocardiogram (echo)
- electrocardiogram (ECG)
- cardiac rhythm monitoring (Holter)
- exercise testing
- cardiac CT
- cardiac MRI
“Echocardiograms and ECGs can be performed in the consulting room at the one-stop appointment, while exercise tests, cardiac CTs and MRIs are offered as additional tests (as needed) and may require a separate visit,” explains Dr Miller.
Private paediatric patients can be seen at Westminster Bridge Consulting Rooms, or in the Walrus zone within Evelina London Children’s Hospital; both offer facilities specially designed for our young cardiology patients to be seen on an outpatient basis.
Referring patients to Evelina London
Although heart murmurs are very common and usually harmless, there is an expectation that children are referred for further investigation of a heart murmur detected at a routine check-up. Common symptoms that patients at Evelina London are referred for include:
- heart murmur
- chest pain
- palpitations
- syncope
To fulfil the expectations of parents, and to reassure them of their child’s heart health, an echocardiogram and ECG are usually recommended for these common symptoms. Further investigations include heart rhythm monitoring, exercise testing and 3-dimensional scans (CT or MRI) provide a full picture of a child’s heart health.
Private patients at Evelina London can be referred from anywhere in the world. Our specialists can often see patients within a week to provide a diagnosis and begin a treatment plan. Dr Miller is the Director of International Services for Evelina London and promotes our services overseas. Due to our department’s reputation, our doctors often see patients referred to us internationally.
“We manage patients across their whole life, we can see patients from before birth and make antenatal diagnoses,” explains Dr Miller. “We then manage the cardiac care for newborns and offer heart surgery as needed, and then follow them through childhood, before transferring them over to adult care in the adult congenital department at St Thomas’ Hospital.”
For our teenage patients and their families, the seamless transition to adult care at our adjoining site, St Thomas’ Hospital, is a factor that sets Evelina London apart, and facilitates the continuation of world-leading heart care.
