The spaces in between: silence as a witness to accompaniment in congenital heart disease
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Updated: Aug 13, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
1Department of Pediatric Cardiology, Children's Health Ireland at Crumlin, Dublin, Ireland.
Insights
Silence in pediatric cardiology care, particularly for congenital heart disease (CHD), offers moments for adaptation and reflection, shaping patient and family experiences beyond clinical activity. Understanding these pauses is crucial for holistic care.
Area of Science:
- Cardiology
- Pediatric Medicine
- Psychosocial Care
Background:
- Pediatric cardiology settings are characterized by constant noise and activity.
- Beneath the clinical bustle, silence plays a significant, often overlooked, role in congenital heart disease (CHD) care.
Purpose of the Study:
- To explore the multifaceted role of silence in the longitudinal care of children and families with CHD.
- To examine how moments of silence impact patients, families, and healthcare professionals.
Main Methods:
- Reflective perspective exploring the concept of silence.
- Analysis of experiences across the continuum of CHD care: fetal diagnosis, infancy, childhood, adolescence, transition to adult services, and survivorship.
Main Results:
- Silence in CHD care is not merely an absence of sound but a space for encountering emotions like uncertainty, fear, relief, and adaptation.
- These silent moments can either be detrimental, causing distress or leaving issues unaddressed, or beneficial, fostering reflection and presence.
- Experiences of silence shape individuals over years of care in ways not typically acknowledged in clinical practice.
Conclusions:
- Silence is a critical, yet underacknowledged, dimension of pediatric cardiology and CHD care.
- Acknowledging and understanding the impact of silence, listening, and presence is essential for providing comprehensive and compassionate care to children and families living with CHD.
Abstract:
Paediatric cardiology is often experienced as a noisy environment. Outpatient clinics, echocardiography laboratories, ICUs, catheterisation suites, and operating theatres are filled with alarms, conversations, machines, movement, and continual clinical activity. Beneath this activity, however, another dimension of CHD care exists: silence. These pauses are not simply absences within clinical work, but moments through which patients, families, nurses, physiologists, and clinicians encounter uncertainty, adaptation, fear, relief, and continuity across time. Across fetal diagnosis, infancy, childhood, adolescence, transition to adult services, and survivorship, silence emerges repeatedly within care. Some silences wound. Others sustain. At times, they create space for reflection and presence; at others, they may leave questions unspoken or emotions unsupported. Over years of care, individuals may be shaped by these experiences in ways rarely acknowledged within clinical medicine. This reflective perspective explores the role of silence, listening, and presence across the longitudinal experience of children and families living with CHD and those who care for them.
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