Editorial: Case reports in pediatric cardiology 2022

Topic Case reports in pediatric cardiology 2022Pediatric cardiology stands as a distinctive subset within the field of cardiology, which typically brings to mind cardiovascular issues prevalent among older individuals.Yet, the truth is that the heart is an incredibly resilient organ, capable of allowing years of relatively symptom-free survival even when significantly damaged.Regrettably, children can and do encounter cardiovascular problems, although their occurrence remains considerably lower compared to the adult population.This reality carries numerous implications.Firstly, due to social and economic factors, scientific and clinical research predominantly focuses on diseases with higher prevalence.Consequently, pediatric cardiology remains, and likely always will be, an area of study that receives less attention.Secondly, as children grow and naturally outgrow surgically implanted prosthetic devices or tissues, this presents unique challenges in their treatment.One of the most captivating facets of pediatric cardiology lies in its close connection to the intriguing realm of congenital heart disease (CHD).This umbrella term encompasses structural or functional abnormalities of the heart or major blood vessels that originate before birth.While most CHD occur independently of other diseases, severe and complex forms often coexist with additional medical conditions.It is essential to acknowledge how CHD can sometimes manifest in unconventional ways, resembling conditions such as ischemic heart disease.A noteworthy example is a case reported by Fallah et al. involving a 2-year-old child with left main coronary artery atresia.This child exhibited classical features of ischemic heart failure, including failure to thrive, a significantly dilated left ventricle, an ejection fraction of 20%-25%, and severe functional mitral regurgitation.The diagnosis was initially suspected due to cardiac magnetic resonance findings, which indicated ischemic heart disease through extensive scarring of the left ventricle.Another intriguing case is presented by Wu et al. involving a term female newborn who presented with congestive heart failure and a grade 4/6 continuous heart murmur in the left upper sternal border.This child was diagnosed with a giant fistula between the right coronary artery and the right ventricle, with an orifice of approximately 2 mm.What makes this case remarkable is the successful percutaneous closure of the fistula using an Amplatzer Duct Occluder II, originally designed for patent ductus arteriosus (PDA) closure.This was possible due to the severe aneurysmatic dilatation of the proximal right coronary artery, which could accommodate both the guidewire and the device itself.