Book Review

Diagnosis and Management of Adult Congenital Heart Disease

N Engl J Med 2004; 350:1918April 29, 2004

Article

Diagnosis and Management of Adult Congenital Heart Disease
Edited by Michael A. Gatzoulis, Gary D. Webb, and Piers E.F. Daubeney. 517 pp., illustrated. Philadelphia, Churchill Livingstone, 2003. $129. ISBN: 0-443-07103-9

Until recently, most children with congenital heart disease (corrected or uncorrected) did not survive past childhood or adolescence. As a result, general internists or cardiologists trained to care for adults had little, if any, need to be knowledgeable or competent in the recognition and management of these disorders. Nowadays, however, children with congenital heart disease often survive to adulthood, and it is therefore important that the physicians who care for them as adults understand the anatomy, pathophysiology, therapy, and prognosis of congenital heart disease. An especially important challenge in young women with corrected or uncorrected congenital heart disease is pregnancy. In addition, adults with congenital heart disease may be at risk for infective endocarditis, and at some time they may require a noncardiac surgical procedure. This book succinctly discusses the numerous kinds of congenital heart disease that physicians may encounter in their adult patients, and it offers a particularly effective discussion of risks and management during pregnancy, noncardiac surgery, and procedures that place patients at risk for endocarditis.

The book has several sections. The first, entitled “General Principles,” is an extensive discussion of cardiac morphology, genetics, procedures (both percutaneous and surgical) for the treatment of congenital abnormalities, arrhythmias, and heart and lung transplantation. Subsequent sections concisely discuss septal defects, valvular disorders, abnormalities of left and right ventricular outflow, and cyanotic conditions, the most important of which are tetralogy of Fallot and Eisenmenger's syndrome. The final sections deal with uncommon and obscure abnormalities, such as univentricular hearts and coronary arterial anomalies. Within each chapter that is devoted to a specific abnormality, the discussion focuses on long-term management, prognosis, and the risks associated with pregnancy, noncardiac surgery, and infective endocarditis. Each chapter contains an abundance of illustrative diagrams as well as numerous morphologic, radiographic, and echocardiographic images. In addition, much of the most important information is highlighted in carefully constructed tables.

This book should serve very effectively as an accessible resource for the internist or cardiologist who does not have extensive training in congenital heart disease. Its organization and highly focused discussions should allow the reader to locate needed information easily and efficiently.

L. David Hillis, M.D.
University of Texas Southwestern Medical Center, Dallas, TX 75390