Year : 2015  |  Volume : 8  |  Issue : 1  |  Page : 93--94

Clinical management of congenital heart disease from infancy to adulthood

TG Abhilash1, Praveen Satheesan1, Raman Krishna Kumar2,  
1 Department of Cardiology, Government Medical College, Thiruvananthapuram, India
2 Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Cochin, Kerala, India

Correspondence Address:
Raman Krishna Kumar
Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Cochin, Kerala

How to cite this article:
Abhilash T G, Satheesan P, Kumar RK. Clinical management of congenital heart disease from infancy to adulthood.Ann Pediatr Card 2015;8:93-94

How to cite this URL:
Abhilash T G, Satheesan P, Kumar RK. Clinical management of congenital heart disease from infancy to adulthood. Ann Pediatr Card [serial online] 2015 [cited 2022 Oct 4 ];8:93-94
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Full Text


Editor: Douglas S. Moodie

Publisher: Cardio text Publishing, Minneapolis, Minnesota, USA

Edition: First Edition, 2014

The book "Clinical Management of Congenital Heart Disease from Infancy to Adulthood" edited by Douglas S. Moodie is a multi-authored textbook that presents information on individual congenital heart diseases that is of practical value to the relatively uninitiated pediatric cardiac professional. It is an excellent attempt in demystifying congenital heart disease. The book has 21 chapters spread over 367 pages, written by experts in Pediatric Cardiology in a structured pattern that include both common lesions as well as complex and less commonly encountered lesions.

The book stands apart from other currently available textbooks in Pediatric Cardiology in lucid presentation of the subject. Each chapter starts with a short introduction, followed by relevant anatomy and physiology. Further down, the lesion has been described according to age from fetus and infants, children and adolescents to adults. In the present scenario of the increasing number of adults with congenital heart disease, the book provides a brief and useful account of the new problems in the management of these cases.

The structuring of each chapter from infancy to adulthood has brought on continuity with some unavoidable repetitions. The book is well illustrated with relevant electrocardiogram (ECG), chest X-ray (CXR), echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) images wherever necessary. The discussion on physical examination section is somewhat limited. Under the diagnostic testing all modalities starting from ECG to cardiac MRI and catheterization is discussed in a clinician-oriented approach. Management issues under medical as well as surgical and interventional modalities have been well brought out.

The 21 chapters written by different authors maintain a seemingly uniform style. Each chapter ends with "tips and tricks" that lists out pertinent practical issues concerning day-to-day practice.

There are a few shortcomings that must be pointed out. The book is almost entirely written by North American authors and therefore presents the perspective of pediatric cardiac practice in advanced nations. The reader from much of the resource-poor environments of low and middle-income countries may not find all their answers to the clinical problems that they commonly face. For example, decision-making in shunts with elevated pulmonary vascular resistance is not dealt with adequately.

Despite a seemingly uniform style, there are inconsistencies in approach that reflect the biases of the individual authors. This is especially apparent when one compares the chapter on ventricular septal defect (VSD) with patent ductus arteriosus (PDA). The chapter on VSD presents a balanced perspective. There is a detailed discussion on natural history that provides an excellent framework for decision-making in individual cases. On the other hand, the PDA chapter is clearly biased toward interventions. The issue of whether a small PDA should be closed in today has not been clarified. There is published literature available on the number of small PDAs that need to be treated to prevent a single episode of endarteritis.

The chapters are arranged in a seemingly random sequence. Perhaps an introductory chapter that discusses physiology and epidemiology of congenital heart diseases, followed by a sequence based on a plan outlined would be of value.

While the books make no claims on being comprehensive, there are a few concerns on the choice of chapters. It is also not clear why cardiomyopathies are included while congenital dysrhythmias are left out. Why is there no section on pulmonary hypertension? Why are vascular tumors included? It would have perhaps helped to include a single chapter that summarizes other rare anomalies such as aorto-pulmonary window, one pulmonary artery from aorta, aorta-left ventricular tunnel, sinus of valsalva aneurysm, cortriatriatum, vascular rings, etc.

Notwithstanding the above-mentioned limitations, this book with its simple language, excellent diagrams, and systematic approach is an excellent addition to the currently available texts in Pediatric Cardiology. This book would serve as an excellent basic text for a beginner and a ready reckoner for a practicing pediatrician and fellows in Pediatric Cardiology.