• Ruth L Collins-Nakai.
• 4C2 Walter Mackenzie Centre, University of Alberta, Edmonton, Canada. rcnakai@telusplanet.net
• Indian J Pediatr. 2002 Apr 1;69(4):315-9.

AbstractCongenital heart defects (CHD) remain a significant cause of death in children, though the etiology remains unknown. One third of all patients born with CHD become critically ill during the first year of life, often within the first month. The reason for consulting a pediatric cardiologist may be urgent or elective and varies with different age groups, and on availability of health care resources. Referral to a pediatric cardiologist is urgently required in those infants with cyanosis, congestive heart failure, shock or arrhythmias, or those dysmorphic infants in whom a syndrome which may involve the heart is suspected. In these cases, referral is for the purpose of specific diagnosis and for life-saving intervention. In the older child, referral is more likely to be related to acquired disease or genetic abnormalities resulting in systemic and cardiac manifestations. A careful history and physical examination will often determine the need for referral. Because many defects can now be successfully treated surgically, it is important to determine prior to referral what resources are locally or regionally available, and what the family's perspective on aggressive therapy is.

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