AHA Medical / Scientific Statement Special Report Cardiovascular Health and Disease in Children : Current Status

Introduction During the past half century there has been major progress in the scientific understanding of cardiovascular conditions in children and youth, and this progress has led to improved prevention and treatment of congenital and acquired heart disease. Following this period of advancement, the current status of our understanding should be reviewed to create a foundation for future scientific efforts. The focus of research and clinical activity in cardiac disease in children has changed during the past 60 years. In the 1930s the major concern among cardiologists caring for children was rheumatic fever and rheumatic heart disease. Interest in congenital heart disease was just beginning. In the 1940s extracardiac operations for cardiac malformations were developed, and in the 1950s the first open-heart procedures involving cardiopulmonary bypass were performed. In the 1960s and 1970s cardiopulmonary bypass became more widely available, and the pediatric patient group undergoing open-heart procedures was expanded from children to neonates and infants. In the 1970s and 1980s, echocardiography and therapeutic catheterization techniques were used in children with cardiac abnormalities. During the past two decades, two other major areas of emphasis have developed: electrophysiology, which allows improved diagnosis and management of arrhythmias in children, and cardiovascular risk factor evaluation in children. In addition, pediatric cardiologists now recognize the need to slow the development of atherosclerosis, a process that often begins in childhood. As the 20th century draws to a close, it is appropriate to review the status of both the major cardiovascular diseases of children and the cardiovascular health of children and youth. This report also describes barriers to continued progress in this important area of cardiovascular medicine, and should help direct research, educational, and other efforts by individuals and organizations interested in cardiovascular disease and the health of children.