What’s New In Pediatric Cardiology

Abstract

1. Phat Pham, MD* 2. Michael Silberbach, MD† 1. *Fellow in Pediatric Cardiology 2. †Associate Professor of Pediatrics, Doernbecher Children’s Hospital, Portland, Ore After completing this article, readers should be able to: 1. Recognize the role of genes in the development of cardiac malformations. 2. Describe advances in noninvasive imaging of congenital heart disease. 3. Characterize the role of interventional catheterization in the treatment of congenital heart disease. 4. Describe emerging concepts for pacemakers and implantable cardioverter defibrillators for use in children. Pediatric cardiology was transformed during the latter half of the 20th century from a field that engendered intense curiosity about the heart in infants and children who had uniformly fatal conditions to an established clinical discipline that routinely offered effective medical and surgical therapies. However, cardiac malformations continue to be the most common birth defects and the leading causes of infant mortality, killing twice the number of children who die from childhood cancer. According to the American Heart Association, more than 2 million Americans are living with congenital heart defects, and more than 91 thousand life-years are lost each year to congenital heart disease (CHD). The Association estimates that the cost of hospital care alone for patients who have CHD exceeds $3 billion per year. Today’s researchers are using the tools of molecular genetics to dissect the circuitry of cardiac embryogenesis and to understand the causes of cardiac malformation. In the 21st century, as the fields of computer technology, information management, and biology become integrated, exciting new approaches to the treatment of childhood heart diseases will become a reality. The following is a brief summary of the recent advances in the understanding of cardiac development, the pathogenesis of heart disease, and the current state of diagnostic modalities and therapies aimed at improving the care of children who have heart disease. Although the “nature versus nurture” debate regarding the origin of CHD continues, it generally is believed that many, if not most, cardiac malformations begin as …