A New Chapter for Little Hearts: Bringing Pediatric Cardiology Back to My Practice

When I started Little Hearts Pediatrics, I knew I wanted to practice pediatrics differently.

I wanted more time with families. I wanted to be able to answer a parent's questions without looking at the clock. I wanted to know my patients well enough to recognize when something was actually different.

And I wanted to be able to use all of my training—not just part of it.

Now that I've joined Direct Pediatrics, I'm excited to be bringing something back into my everyday practice that has been a very important part of my career for years:

Pediatric cardiology.

So, yes…I'm seeing cardiology patients again.

Before I started Little Hearts Pediatrics, I spent years working as a pediatric cardiologist.

I completed my pediatric residency in Louisville and then completed fellowship training in pediatric cardiology at Washington University in St. Louis. I went on to practice pediatric and fetal cardiology at children's hospitals before eventually deciding to build the kind of pediatric practice I wanted for my own family and for the families I cared for.

I have always loved pediatric cardiology.

But I also love general pediatrics.

That's one of the things that makes this next chapter so exciting for me.

I don't have to choose.

I get to be a pediatrician and a pediatric cardiologist.

What does a pediatric cardiologist actually do?

A pediatric cardiologist evaluates children and adolescents when there is a question or concern about the heart or cardiovascular system.

Sometimes that concern is something a parent has noticed.

Sometimes it's something your pediatrician hears or sees during a routine visit.

And sometimes it's simply a symptom that deserves a little more investigation.

Some of the concerns I can evaluate include:

• Heart murmurs

• Chest pain

• Dizziness

• Fainting or passing out

• Racing or irregular heartbeats

• High blood pressure

• High cholesterol

• Abnormal cardiac testing

• Family history of significant heart disease or sudden cardiac death

And sometimes the most reassuring answer I can give a family is:

"Your child's heart is okay."

That is an important part of pediatric cardiology, too.

"My pediatrician heard a murmur. Should I be worried?"

This is one of the most common questions I hear from parents.

Hearing that someone found a heart murmur in your child can be scary. The word "heart" tends to get everyone's attention.

But many heart murmurs in children are innocent, meaning they are not caused by a structural problem with the heart.

That doesn't mean every murmur should be ignored.

It means that a careful history, physical examination, and sometimes additional testing can help determine whether a murmur is something we need to investigate further.

One of the things I enjoy most about pediatric cardiology is being able to take that scary moment and help a family understand what is actually happening.

Sometimes we find a problem that needs to be followed.

Sometimes we find something that needs treatment.

And sometimes we find a completely normal heart and give everyone some reassurance.

What about chest pain?

Chest pain in a child can be terrifying for a parent.

The good news is that most chest pain in children is not caused by the heart.

Children can have chest pain from muscles, inflammation, reflux, respiratory illnesses, anxiety, and many other causes.

But there are certain types of chest pain that deserve a closer look—particularly chest pain associated with exercise or other concerning symptoms.

That's where having someone who understands both general pediatrics and pediatric cardiology can be helpful.

My job isn't to assume every symptom is a heart problem.

My job is to figure out whether the heart could be involved—and if it isn't, help figure out what else might be going on.

Dizziness and passing out are common, too.

Dizziness and fainting can be especially confusing for teenagers.

I recently wrote about this because it is something I see frequently in pediatric practice.

In many otherwise healthy adolescents, dizziness and fainting are related to changes that happen during puberty, including changes in the way the body regulates blood pressure and heart rate.

For many children, increasing fluids and salt can make a significant difference.

But not every child fits the same pattern.

Sometimes we need to look more closely at the symptoms, the circumstances surrounding the episode, family history, and the child's overall health. And when lifestyle changes aren't enough, there are medications and other treatment options that can sometimes help.

The most important part is taking the time to understand what is actually happening.

I also see kids with high blood pressure and high cholesterol.

These are two areas of pediatric cardiology that I think deserve more attention.

We tend to think of high blood pressure and high cholesterol as adult problems.

They're not always.

Children and adolescents can have elevated blood pressure or cholesterol, and sometimes there is a family history that makes early evaluation particularly important.

The goal isn't to make a child feel like they're "sick."

The goal is to identify concerns early, understand why they are happening, and work with the child and family on a plan that makes sense.

That might involve lifestyle changes, monitoring, additional testing, or treatment depending on the individual child.

Why am I so excited about combining pediatrics and cardiology?

Because this is how I have always wanted to practice medicine.

I don't want to see a child as a diagnosis.

I want to know the child.

I want to know the family.

I want to know what has been happening at home, what concerns the parents, what the child is worried about, and what questions haven't been answered yet.

And I want to have enough time to actually talk about those things.

One of the reasons I chose the direct primary care model is because I believe medicine works better when there is time for relationships.

Now I get to bring that philosophy into pediatric cardiology, too.

A child can come to see me because their pediatrician heard a murmur.

Or because they've been getting dizzy at school.

Or because they've passed out.

Or because they have chest pain during exercise.

Or because their blood pressure has been elevated.

And I can approach that concern not just as a cardiologist, but as their pediatrician.

I think that's pretty special.

A little bit of the old Little Hearts—and a lot of something new

The name Little Hearts Pediatrics was originally inspired by my love of caring for children's hearts.

Now, as I begin this next chapter at Direct Pediatrics, it feels a little bit like coming full circle.

I'm still providing general pediatric care.

I'm still seeing sick kids.

I'm still taking care of newborns, adolescents, and everything in between.

I'm still providing pediatric weight management.

But now I'm also opening the door for families who need pediatric cardiology care.

And I'm really excited about it.

Looking for a pediatric cardiologist in Louisville?

If your child has a heart murmur, chest pain, dizziness, fainting, palpitations, high blood pressure, high cholesterol, an abnormal cardiac test, or another cardiovascular concern, I would be happy to talk with you about whether a pediatric cardiology evaluation is appropriate.

I'm seeing patients at Direct Pediatrics in Middletown in Louisville.

And whether your child needs a cardiology evaluation or simply needs a pediatrician who will take the time to listen, my goal is the same:

Take care of the whole child.

That's what I've always loved about pediatrics.

And now I get to do it with a little more of my cardiology training back in the picture.

I'm really looking forward to this next chapter.

Meagan Peek, MD