Paediatric cardiologist in Latviawhere to get treatment, how to verify certification, what this doctor does

A paediatric cardiologist diagnoses and treats heart and vascular disease from birth to age 18. They assess murmurs, rhythm disorders and exercise tolerance, perform and interpret echocardiography, and continue outpatient follow-up after surgical correction of a defect.

• Congenital heart defects and care after their surgical correction
• Heart murmurs and suspected heart failure
• Rhythm disorders, including those recorded on an ECG
• Cardiomyopathy, or disease of the heart muscle
• Fainting during physical exertion
• Repeatedly raised blood pressure in a child

A family doctor or paediatrician is enough while the child is growing normally and has no symptoms. A paediatric cardiologist is needed when a murmur is heard, when there is fast heartbeat and breathing, an enlarged liver, heavy sweating or fatigue on minimal exertion, or when young relatives have died of heart disease.

Paediatric cardiology in Latvia has no separate sub-specialties. What differs in practice is the range of methods an individual doctor performs: transthoracic, transoesophageal and fetal echocardiography, plus work in theatre and intensive care alongside cardiac surgeons.

• Six years of medical study and a doctor's degree, at RSU or the University of Latvia.
• Residency in paediatrics. Entry to the paediatric cardiology programme requires a copy of a valid paediatrician certificate, or university confirmation of third-year residency in the base specialty "Pediatrs". For doctors without the paediatrics specialty the programme runs six years.
• Residency in paediatric cardiology. Programme page: RSU residency programme. Residents learn transthoracic, transoesophageal and fetal echocardiography, bicycle ergometry, and interpretation of cardiac imaging.
• After the third year of study the resident sits the state examination: a theory paper, defence of a research project, and a record of independently performed procedures.
• The certificate is valid for 5 years. Recertification requires 250 continuing education points, at least 60 per cent tied to the base specialty, plus a 48.38 EUR fee.
• Entry in the practitioners register must be renewed every 5 years.

• Languages. Consultations run in Latvian and Russian, and some doctors also work in English. Confirm when booking.
• Experience. Some paediatric cardiologists also teach at RSU and publish research, and clinic doctor profiles say so.
• Age groups. Paediatric cardiologists see patients from birth to 18. Adults with congenital heart disease move to an adult cardiologist.
• Tests on site. If an echo, ECG or Holter monitoring is likely, a provider that can do them at the same visit saves a trip.
• Second opinion. A child's legal representative may freely choose the doctor and institution, including asking a second paediatric cardiologist for an assessment.

• Bring every discharge summary and specialist report from hospitals and outpatient clinics, plus the results of any earlier ECGs.
• For school-age children a sports doctor's report is useful. Prepare information on the medicines the child takes.
• Find out whether close blood relatives have had heart disease or rhythm disorders. This helps the doctor reach a diagnosis faster.
• At the visit the doctor takes a history from parents and child, listens to the heart with a stethoscope, and orders an ECG, echocardiography, Holter monitoring or other tests as needed.
• Within a single visit the doctor gives recommendations on daily life and physical activity, prescribes medicines and further treatment, and arranges other specialist consultations if required.

Children under 18 are among the groups exempt from patient co-payments, so a state-funded paediatric cardiology consultation on referral costs the family nothing. A private visit is paid by the parents or an insurer, and tests are charged separately from the consultation.

• Echocardiography for childrenPrice EUR: 100.00Provider: Veselības centrs 4
• Patient co-payment for a child under 18Price EUR: 0.00Provider: NVD
• Private paediatric cardiology consultationPrice EUR: per clinic price listProvider: ARS medicīnas klīnika, Premium Medical

No dedicated paediatric cardiology association appears in the our records. The Children's Clinical University Hospital states that Latvia's paediatric cardiologists are members of the European association for paediatric cardiology.

Certificates in paediatric cardiology are issued by the Certification Council of the Latvian Medical Association, founded in 1988. The sector regulator is the Health Inspectorate.

If you have doubts about the care a child received, raise them first with the institution's management, which must operate a complaints and suggestions system. If that does not resolve it, the child's legal representative may submit a written complaint to the Health Inspectorate no later than two years after the alleged infringement. It is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.