Mind-boggling advances
in cardiac care

aFall 1999

THE PRESENT ISSUE  of The Child's Doctor is devoted to pediatric cardiology and cardiovascular surgery. The variety of contributions here gathered reflects the admirable advances made in the care of children afflicted with heart disease. Indeed, the speed of this progress boggles the imagination.

From a historical perspective, it was not too long ago that physicians learned to recognize disorders of the heart's rhythmicity. Sir James Mackenzie (1853–1925) first described auricular fibrillation and extrasystoles ("the dropped beat") in the early part of the present century. Paroxysmal tachycardia was identified by Léon Bouveret (French physicians called it la maladie de Bouveret), who died in 1929. Scarcely could these and other pioneers have imagined the rapidity with which their followers elaborated upon their findings. Today we can diagnose a number of rhythm disorders with exquisite precision, early in life, and at times even before the patient is born, while still a fetus in the mother's womb. Fortunately, as the review of Dr. Johnsrude in this issue of The Child's Doctor makes clear, we can also count on technical know-how to restore lost normalcy by means of implantable electronic devices.

Until relatively recently, there were cardiac diseases of purely pathologic interest: the corrective operations were associated with high morbidity or avoided because of a prohibitively high risk. Cardiac transplantation in such cases is now accomplished with increasingly encouraging results, as reviewed by doctors Pahl, Backer and Mavroudis.

A comparable claim may be made for therapeutic catheterization. In 1929, Werner Forssman, a German physician, was the first to use fluoroscopy to introduce a catheter into the heart (his own, while he watched the screen with a mirror!). Blalock and Hanlon, Americans, performed the first successful atrial septectomy in 1948. Current therapeutic applications are discussed in doctor David Wax's article.

Many of these stunning advances, formerly restricted solely to large teaching hospitals in urban sites, are now being made available to patients anywhere, including those in remote areas. Telecardiology, as Dr. Catherine Webb informs us in this issue, is here to stay. Images, tracings, cardiac sounds, laboratory findings, and other data, all can be instantaneously transmitted via the wonder of modern telecommunications.

Sick children stand to benefit, and all of us at Children's Memorial ought to feel proud to belong to the team that strives to make the alleviation of cardiac conditions possible.

Copyright © 2008 by Children’s Memorial Hospital. All rights reserved.