Pediatric Echocardiography Echocardiography (an echocardiogram, echo or heart ultrasound) is the procedure to generate moving images of the heart. It provides an in-depth assessment of various structural and functional attributes of the heart. Echocardiograms use high-frequency sound waves that are reflected off the surfaces of the heart to create a picture on a TV monitor. Images are generated by a transducer (like a microphone) which is placed on the chest with warmed gel. Two-dimensional, colour-enhanced images then appear on the screen. Pediatric echocardiography is a non-invasive, pain-free procedure that is performed by a specially trained pediatric cardiologist. Unlike adults, heart disease in children are mostly structural defects and echocardiogram is the most important and pivotal investigation for diagnosis and further management. Various modes like 2D-mode, M-mode, Colour Doppler, 3D mode etc are available in the present era. Thus even the most complex of the congenital heart defects can be reliably diagnosed by a trained pediatric cardiologist using the above tools. Congenital heart disease can affect children of any age including preterm neonates. It takes great amount of skill to perform echocardiogram on small neonates. However, it’s the toddlers and young children who often pose the biggest challenge. Various engaging techniques are used by a skilful pediatric cardiologist to get the job done in a restless child. Sometimes mild sedation like oral Triclofos (Syrup Pedicloryl) may be needed to put the child to sleep to perform a comprehensive echocardiographic evaluation.