Paediatric Cardiology, 2nd edition, volumes 1 and 2
Robert H. Anderson, Edward J. Baker, Fergus J. McCartney, et al, eds.
1036 pp (vol 1) and 1036 pp (vol 2). London: Churchill Livingstone; 2002. $399.00. ISBN: 0-4430-7990-0
A long-awaited second edition of Paediatric Cardiology has finally been published, after a period of 15 years. The chief editor, Robert Anderson, is one of the founding fathers of the field of cardiac morphology. The second edition has retained much of its original focus on cardiac morphology, laying out the “heart” of the subject, as it were. Its persisting emphasis on the importance of understanding the morphology of congenital heart disease (CHD) comes from having retained most of the primary authors and many more of the illustrations from the first edition. Indeed, improving non-invasive imaging technology has shifted the illustration of anatomy questions from the autopsy table to the echo laboratory. The new edition has bravely moved on from its self-confessed “Old World thinking” on nomenclature to the present broader horizons of pediatric and adult CHD and “classical terms have been translated to their English equivalents.”
In his opening chapter on terminology, Professor Anderson clarifies that it is not their intention to continue detailed debates, but rather to leave the reader with a choice. The sequential segmental analysis proposed by him has found widespread support in the specialty, and he states, “By and large, there is no right or wrong way of describing the heart, simply different ways (Van Praagh 1995; Anderson 1996).”
The first sections, which are comprehensive chapters on incidence, epidemiology, and associations of CHD, are followed by elegantly written ones on pulmonary circulation and basic hemodynamics. From these familiar though updated topics, the reader is led to the recently introduced chapters on molecular biology, myocardial development, embryology, and physiology of the developing heart, which are, for the most part, adequately detailed and well illustrated.
A very straightforward chapter on magnetic resonance imaging (MRI) does not do quite enough justice to advances in cardiac MRI, which is not surprising, considering its most recent reference is from 1994! Most of the illustrations are poor quality spin echo gated MRI sections, and there is no mention of MR angiography or 3D methods of MR reconstruction, which have made such an impact on diagnosis and management in complex CHD and adult CHD. Similarly, the chapter on radionuclide imaging, while silent on lung perfusion studies, does not fully bring out the potential applications of these methods as well.
Andrew Bush comprehensively deals with issues regarding pulmonary vascular disease in this chapter. The next chapter, entitled “Lung Function and Exercise Testing,” covers a lot of detailed information on lung function but lacks information regarding essential aspects of exercise testing. A comprehensive overview of CHD in adolescents and adults is very concise and well referenced, with information on the latest outcome studies, and is highly recommended reading, even for a general internist.
The essential impression from the “bread and butter” chapters on individual types of congenital defects is one of clear terminology, well-illustrated pathology, and a focus on chamber identification and segmental analysis. Accompanying diagrammatic representations of the conduction pathways are useful indeed. The echo images are of poor quality, however, and color Doppler images are sequestered in a separate section for each volume. Indeed, these images will be a letdown to most readers, especially as many chapters have used the same echo images as were in the first edition. There are exceptions, however, and the chapters on hypoplastic left heart, double outlet ventricle, and coronary artery anomalies have more updated and better quality echo pictures.
On the whole, this second edition of Paediatric Cardiology, written and edited by some of the leading figures in the field, is a reader-friendly resource that stresses the fundamentals of congenital heart disease anatomy and physiology as a groundwork for reading and should be supplemented with more recent publications. The strategy for taking best advantage of the material in this book would be a deliberate review, chapter by chapter, to absorb basic concepts of the various aspects of congenital heart disease anatomy, physiology, diagnosis, management, and natural history in a systematic, sequential fashion. As prepared and organized, it would be less suitable for a quick, or even an exhaustive reference on individual lesions.