"Although it is usually possible to make a diagnosis of congenital heart disease, a diagnosis of especial lesion, as a rule is impossible" Dr. Thomas Morgan Rotch wrote in the first ever textbook of Pediatrics published in the year 1896. Defying this statement, pediatric cardiac diseases, congenital or acquired, are not only well recognized entities today but are also getting successful remedial interventions. Knowing this, Indian Academy of Pediatrics and its Cardiology Chapter made joint efforts to bring out consensus guidelines on congenital heart diseases, rheumatic fever and rheumatic heart disease(1,2).

Historically, Pediatric cardiology as a sub-specialty owes its origin to pediatrics and cardiology. The American Heart Association started a subgroup called Council on Rheumatic fever (1945) which later became Council on Cardiovascular Diseases in Young and accommodated Congenital Heart Diseases (CHD) in 1950. Pediatric Cardiology received its formal recognition as subspecialty, first time in 1961 internationally. In India, Cardiology chapter was founded as a subspecialty group of IAP in1990. Pediatric Cardiologic Society of India was founded much later in year 1997.

Evidently, the target population of structural heart diseases is neonatal and infant population. Conversely, acquired heart diseases including acute rheumatic fever, rheumatic heart diseases, Kawasaki disease, myocardial diseases, and rhythm disorders also influence children below fifteen years of age. Hence, pediatricians have the role of diagnosticians as well as caretakers. Despite all its virtues, Pediatric cardiology is lagging behind, particularly at suburban and rural areas where even simple diagnostic modalities are not available. With growing number of institutions dealing with pediatric cardiac patients, the sensitization towards the problem is increasing. This can not be directly converted in to therapeutic advantage for the simple reason that majority of the population is poor and below poverty line. Therefore, the upcoming private cardiac set up may not meet the enormity of demand amongst economically deprived India. Pediatricians, with growing awareness about cardiac ailments can play a pivotal role in its management.

IAP conducted an online survey to assess the knowledge, attitude, practices and interest of the pediatricians about the subject. The experience was an eye opener. It seemed that we underestimated the level of interest amongst pediatricians. Many valid points like lack of consensus guidelines on management of ARF/RHD were highlighted by responders.

In pursuit of upgraded knowledge and practices in field of pediatric cardiology, IAP plans to undertake following measures:

Let all the pediatricians come out of concepts of ‘age’ and ‘weight’ cutoff’s and make zealous attempt for a proper diagnosis and referral. This younger generation treated or untreated, is going to grow as adults and would face all the complications. A girl harboring a prosthetic valve, on anticoagulants would be a future mother and face the problems of anticoagulant therapy. Many babies with congenital heart lesions need multiple surgeries. We have a lifelong commitment towards them.We have to imbibe them with not only physical but mental and emotional strength to win their deserved place in the society and nation.

"Every child born into this world is a new thought of God, an ever fresh and radiant possibility."

R K Agarwal,
President IAP 2008,
R K Hospital,
5/A, Madhuban, Udaipur 313 001, India.
Email: [email protected]