Diagnosis and Management of Common Malformations of the Heart

ACCURATE diagnosis and the proper management of children with malformations of the heart becomes increasingly important as more and more malformations become amenable to surgery. Even patients who cannot be helped by surgery should be encouraged to lead useful lives. In many instances it is quite as much the doctor's attitude as the malformation which makes an invalid out of the child. Fortunately a ilumber of malformations can be diagnosed with comparative ease by simple clinical methods, without recourse to cardiac catheterization or angiocardiography. The latter procedures are useful adjuncts, but by themselves seldom give the correct answer. Furthermore, they are not innocuous procedures; therefore they should not be used routinely, but only to obtain specific information on some particular point. The purpose of this paper is to review the common malformations of the heart which can be diagnosed clinically and to give the clinician a number of hints concerning the diagnosis and also some general principles concerning the management of these children.