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[Cardiovascular diseases in childhood].

Der Radiologe 2015 July
Cardiac imaging in childhood poses significant challenges for the instrumentation and the operator. Small cardiac structures, high heart beat rates, non-compliant or sedated patients and in addition to the challenge of detecting acquired heart diseases, a broad spectrum of congenital heart defects (CHD) needs to be addressed, preferably without the burden of ionizing radiation. These challenges require not only accurate anatomical imaging but also a comprehensive assessment of hemodynamic and functional parameters for prognosis and risk stratification. With an incidence of 1 % among all live births, CHDs are the most frequent form of congenital organ dysplasia. Advances in the diagnostics and treatment of even very complex forms of CHD lead to a higher number of patients requiring follow-up with cardiac imaging in childhood. As an example congenital defects, such as tetralogy of Fallot or valvular regurgitation need regular assessment of cardiac volumes and function. Arrhythmogenic right ventricular cardiomyopathy requires recognition of fatty infiltration in the myocardium and in hypertrophic cardiomyopathy or myocarditis evidence of scar tissue or fibrosis portends a poor prognosis for the patient. For adequate assessment of the hemodynamics of complex CHD, the investigator must be aware of the patient's medical history in order to judge the course of the circulation that might diverge from the norm. A close knit cooperation and communication between all involved medical sub-specialties therefore needs to be guaranteed.

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