Task Force 6: Pediatric cardiology.

Introduction Pediatric cardiology was established as a subspecialty of the American Board of Pediatrics and began certification in 1951. Although the field initially comprised cardiologists with both internal medicine and pediatric training, the paths of adult and pediatric cardiology have diverged until presently there is very little overlap of interest and expertise in the areas of noninvasive and invasive diagnostic techniques, arrhythmia management and the medical and surgical treatment of infants and children with congenital heart disease . A growing area of considerable overlap is the care of the adult with congenital heart disease . The clinical foundation of pediatric cardiology is early diagnosis and intervention for congenital heart disease . Because of emphasis on the infant and fetus, it has become necessary for the pediatric cardiologist to have a full understanding of the developmental biology of the immature cardiovascular system, as well as comprehensive knowledge ofthe wide spectrum of cardiovascular diseases encountered in this age group . Likewise, cardiovascular involvement in systemic illnesses, such as acquired immunodeficiency syndrome (AIDS) and Kawasaki disease, and the multisystem management of children receiving heart transplants requires an in-depth knowledge of general pediatric care. Thus, it is imperative for cardiologists caring for children to be fully trained in pediatrics as well as in cardiovascular disease . There are few areas of medicine embracing as many aspects of patient care as pediatric cardiology . The variations of cardiac malformations are so numerous that even in a tertiary care center specializing in the care of complex patients, lesions are encountered for the first time on a regular basis . Each anatomic variation has distinct physiologic and evolutionary consequences . Pediatric cardiologists are involved regularly with contin>artzy outpatient care, inpadent care of the critically ill and performance of highly technical diagnostic and interventional techniques. It is no longer feasible for a single physician to be truly expert in all areas because of the elaboration of highly specialized skills in the areas of fetal mnedicir' , interventional catheterization and complex arrhythmia management. Hence the tendency JACC Vol. 24, No . 2 August 1994 :275-325