Of every 1000 newborns, 7-8 children suffer from congenital heart or great arteries defects. Such abnormalities are not so serious to be operated on. If we assume that about 700,000 children are born in Germany every year, we are to expect about 5,000 new patients every year. Due to the great progress in the diagnosis, surgical treatment and post-operative treatment of children with congenital heart problems, currently about 85% of patients reach mature age.
Pediatric cardiologists are pediatricians with specialization in the field of pediatric cardiology. When receiving higher medical education, they get training in pediatrics for 5 years. Then they specialize in the field of pediatric cardiology, which requires training over the next three years. During the training, pediatric cardiologists study auxiliary diagnostic tools in order to be able to diagnose and treat congenital heart defects, cardiac rhythm disturbances (arrhythmias) or other heart diseases. Along with clinical studies, such ancillary diagnostics include electrocardiogram, ultrasound examination of the heart (echocardiography and dopplerography), cardiac catheterization and magnetic resonance imaging.
Among pediatric cardiologists there are specialists who have mastered methods which help them treat congenital heart defects in the cardiac catheterization laboratory, or at least reduce their negative impact on blood circulation. The so-called interventional cardiac catheterization includes atrial septal defect closure (by installing a small double umbrella), stretching the narrow places of the heart valves with balloon catheters and others. Other specialists among pediatric cardiologists concentrate on diagnosing and treating heart rhythm disturbances. With the help of a special cardiac catheter it is possible to learn and analyze the exact causes of chronic arrhythmia (the so-called electrophysiological study). It is often possible to permanently eliminate arrhythmia in patients with chronic cardiac arrhythmia. In the cardiac catheterization laboratory the part of the cardiac muscle responsible for arrhythmia is removed with a special cardiac catheter (undergoes ablation).
What diseases do pediatric cardiologists treat?
- Congenital heart disease
- Defects in the septa of the heart
- Atrial septal defect
- Deficiency of the interventricular septum of the heart
- Atrioventricular septal defect
- Narrowing of the heart valves (for example, narrowing of the pulmonary artery valve ‒ pulmonary stenosis; constriction of the aortic valve ‒ aortic stenosis)
- Complex congenital heart diseases
- Fallot tetrad (deficiency of the interventricular septum and narrowing of the pulmonary artery valve)
- Double outlet right ventricle (the discharge of both arteries from the right ventricle)
- Right ventricular hypoplasia (the underdevelopment of the right ventricle and right ventricular valve contraction)
- Left ventricular hypoplasia (the underdevelopment of the left ventricle and the underdevelopment of the left ventricular valves)
- Single ventricle/ single-ventricle heart defect (heart with no left ventricle)
- Transposition of large arteries (congenital abnormal position of the heart vessels)
- Common arterial trunk (a single artery instead of two arise from the heart)
- Pulmonary artery atresia (the closure of the pulmonary artery valve)
- Tricuspid valve atresia
- Anomalies of the main coronary arteries
- Stenosis of the aortic isthmus (aortic narrowing at the end of the aortic arch)
- Interrupted aortic arch
- Open arterial duct
- Aortopulmonary window (a defect between the aorta and the pulmonary artery)
- Vascular rings
- Anomalous pulmonary venous drainage
- Acquired heart diseases
- Myocarditis (an inflammatory disease of the heart muscle)
- Kawasaki syndrome (an inflammatory disease of the arteries with lesions predominantly in the coronary arteries)
- Rheumatic attack
- Atherosclerosis with congenital lipid metabolism disorder
- Impaired heart rate
- Supraventricular tachycardia (for example, premature ventricular excitation syndrome)
- Ventricular tachycardia
- Supraventricular / ventricular extrasystole
- Long QT interval syndrome
- Atrioventricular block
Pediatric cardiologists work in cardiology centers which specialize in the treatment of children and adolescents with congenital heart diseases. A professional team of pediatric cardiologists, pediatric cardiac surgeons (that is, cardiac surgeons who possess a high level of professionalism in treating children with congenital heart defects), anesthesiologists, junior and middle medical personnel, perfusionists and social workers are required for such treatment. In addition, there are pediatric cardiologists who work in children’s clinics and take care of the optimal treatment of children with heart defects. There is also a large-scale network of pediatric cardiologists with a permit for private practice which has been working for several years. The main focus of the clinics’ work is outpatient care of patients with congenital heart defects. To treat patients these specialists closely cooperate with each other regionally.
Congenital heart defects are very diverse. Heart defects often differ in small, yet, important for treatment details. So, successful treatment of children with congenital heart defects or other heart diseases requires accurate detection of all details of heart disease and individual treatment planning. Heart diseases in childhood are very different from the predominantly acquired heart diseases in adulthood. That is why children and adolescents with congenital and acquired heart diseases need special medical care which is guaranteed by pediatric cardiologists trained specially for this purpose.
Pediatricians with specialization in pediatric cardiology are regarded not as purely narrow specialists. They are doctors who provide children and adolescents suffering from cardiovascular diseases with comprehensive medical care, as there are often problems outside the heart that need to be taken into account in treatment.