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The Future of Pediatric Cardiology: Is There One?

"There are few areas of medicine embracing as many aspects of patient care as pediatric cardiology. The variations of cardiac malformations are so numerous, that even in a tertiary care center specializing in the care of complex patients, lesions are encountered for the first time on a regular basis. Each anatomic variation has distinct physiologic consequences. Pediatric Cardiologists are involved regularly with continuity outpatient care, inpatient care of the critically ill, and performance of highly technical diagnostic and interventional techniques. It is no longer feasible for a single pediatric cardiologist to be truly expert in all areas because of the elaboration of highly specialized skills in the areas of fetal medicine, interventional cardiology, complex arrhythmia management, and adult congenital heart disease. The tendency, therefore, exists for pediatric cardiologists to practice together in a group setting either in a university, children's hospital, or private subspecialty groups." Furthermore, the requirements for an appropriately designed and staffed cardiac catheterization laboratory and highly sophisticated noninvasive testing equipment have resulted in the distribution of pediatric cardiologists in densely populated urban areas. Compared with the number of adults with coronary and rheumatic heart disease, ap-