IAP Speciality Series on Pediatric Cardiology R Krishna Kumar, Shakuntala S Prabhu, M Zulfikar Ahamed
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1IAP SPECIALITY SERIES ON Pediatric Cardiology
2IAP SPECIALITY SERIES ON Pediatric Cardiology
Editors R Krishna Kumar MD DM FACC FAHA Clinical Professor and Head, Department of Pediatric Cardiology Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India Shakuntala S Prabhu MD DCH Professor of Pediatrics and In-charge Div. of Pediatric Cardiology BJ Wadia Children's Hospital Acharaya Donde Marg, Parel, Mumbai, India M Zulfikar Ahamed MD(Ped) DM (Cardiology) Professor and Head of Pediatric Cardiology Department of Pediatrics Government Medical College Thiruvananthapuram, Kerala, India
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Pediatric Cardiology
© 2008, Jaypee Brothers Medical Publishers
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First Edition: 2008
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4Contributors 7Message
Dear Colleague,
It gives me great pleasure to present this IAP Speciality Series book on Pediatric Cardiology.
Need to have IAP books in pediatric specialities was always felt by many. While we have many such speciality books written by individuals, we do not have these books under the fold of IAP. We can standardize the format, contents, style and size by having these books under the banner of IAP. Looking at the need of having IAP Speciality Books and availability of experts within IAP to do this job, we had targeted to publish books on major pediatric specialities under IAP Speciality Series.
IAP published four books under IAP Speciality Series, i.e. Pediatric Infectious Diseases, Rational Antimicrobials Practice in Pediatrics, Pediatric HIV and Pediatric Hematology and Oncology last year. These books were highly appreciated by one and all and this has encouraged us to bring out three more books under the IAP Speciality Series this year, i.e. Pediatric Quiz for Undergraduates 1996-2006, Pediatric Intensive Care and Pediatric Gastroenterology.
I am thankful to Editors Dr Krishna Kumar, Dr Shakuntala Prabhu and Dr Zulfikar Ahamed for their wonderful and painstaking work. I am thankful to the experts who have contributed articles in this book and the IAP office bearers 2006 and 2007 for helping us with concept and editorial work of the entire IAP Speciality Series. I am sure you will find this book useful and informative and hope that this book becomes a desk companion for all the practicing pediatricians and postgraduates in pediatrics.
Yours sincerely
Nitin Shah
Editor-in-Chief, IAP Speciality Series
8Preface
Impressive advances have occurred in Pediatric Cardiac Care in India over the last decade. Several new programs have been established and the quality of care has progressively improved. Infant heart surgery is now becoming increasingly available in many Indian centers. Pediatric cardiology is now recognized as a distinct subspecialty and dedicated fellowship training programs have been initiated in selected centers in India. However, several challenges continue to exist. The number of centers is not enough to take care of the number of affected children and cost of care continues to be prohibitive for the average Indian family. Large parts of India still do not have access to pediatric heart care because there are no centers even in many larger states. Most postgraduate training programs in India are in centers which do not offer specialized pediatric cardiac services. As a result the average Indian pediatric postgraduate trainee receives very little systematic exposure in pediatric cardiology.
While it is absolutely clear that early recognition and timely intervention has been the key to successful outcome of children with heart disease, the average pediatrician in India has limited opportunities to improve his or her understanding in diagnosis of pediatric heart disease. This book attempts to bridge this gap and aims to provide basic information required for a practising pediatrician and a postgraduate student in pediatrics. The entire text throws light on clinical approach and seeks to examine relatively common problems encountered by practising pediatricians. The text begins with the diagnostic tools required to identify heart disease and the chapters include clinical examination,X-ray, ECG, echocardiography and diagnostic catheterization. Common clinical problems such as chest pain, syncope and arrhythmias are dealt with in the next set of chapters. Congenital heart diseases are described under conventional categories. Specific congenital heart conditions have not been dealt with in great detail and readers will need to refer to comprehensive textbooks for details on individual conditions. Acquired conditions such as rheumatic fever, Kawasaki disease, myocardial and pericardial diseases and endocarditis are all described in separate chapters. The final set of chapters includes a variety of special issues relating to pediatric heart care. A chapter on Follow-up of Children Following Cardiac Surgery and Percutaneous Interventions is specifically included.
We thank all contributors who made this book possible and the Indian Academy of Pediatrics for giving us the opportunity to write this textbook. We also wish to specially acknowledge the editorial assistance of Dr Sumitra Venkatesh and Dr BRJ Kannan. Given the fact that this is the first edition, we recognize that there will be considerable scope for improvement. We sincerely solicit feedback from our readers. We would use them to improve the quality of next edition.
R Krishna Kumar
Shakuntala S Prabhu
M Zulfikar Ahamed