Role of the General Pediatrician in Pediatric Cardiology
Alexander S. Nadas MD1
1 Chief, Department of Cardiology, Children's Hospital Medical Center, and Professor of Pediatrics, Harvard Medical School, Boston
The Sub-board of Pediatric Cardiology was established in 1961, and up to the present it has certified slightly more than 500 individuals in this country and abroad. The cardiology section of the American Academy of Pediatrics has 318 members; most, but not all, are certified by the Sub-board. In 1979, 3.4 million live births occurred in the United States. Taking the generally accepted figure for live-born infants having congenital heart disease as 8/1,000, it is reasonable to assume that about 27,000 babies were born with congenital heart disease in 1979. According to our own figures from the New England Regional Infant Cardiac Program, more than one third of these, at least 10,000 newborns, represent disease with serious, even critical, manifestations within the first year of life.
It seems quite obvious from these few numbers, that certified pediatric cardiologists, concentrated mostly in university centers and metropolitan areas, cannot hope to deliver adequate continued care to these large numbers of critically ill infants arriving every year, nor to the high percentage (more than 90%) of survivors of the total 8/1,000.
In my view, the logical person to give daily care to these patients is the general pediatrician acting under the intelligent guidance of a pediatric cardiologist.
