日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Congenital heart disease is a common condition in children, and general pediatricians are frequently called in to access the hemodynamics of the disease. The role of circulation is to deliver enough oxygen, taken up by the lungs, to each organ in the body while maintaining cardiac output for that purpose. If there are defects or shunts in the heart or between large blood vessels, the direction and amount of the shunt are defined by the difference in systemic and pulmonary vascular resistance in posttricuspid shunts (ventricular septal defect, patent ductus arteriosus, etc.) and by the difference in compliance between both ventricles in pretricuspid shunts (atrial septal defect). When it comes to managing various congenital heart diseases, it is simple to understand whether the disease is classified by an increase or decrease in pulmonary blood flow. When a general pediatrician encounters a patient with undiagnosed congenital heart disease, the least they should do is determine whether the disease requires patent ductus arteriosus and whether oxygen administration is necessary. Although echocardiography is the simplest and most useful tool for evaluating children’s hemodynamics at bedside, pediatricians should make a comprehensive decision by including other modalities.