Angiocardiography in heart disease in children.

We present here some of our experience of angiocardiography; it deals exclusively with children and infants as a result of our working in a children's hospital.* When a careful clinical examination, electrocardiograms, X rays, and the simple laboratory tests do not make the diagnosis certain, we have two principal procedures: heart catheterization with study of the pressures and gas content from samples obtained in different chambers of the heart, and in addition, angiocardiography. Although the first procedure is of great value, it is very difficult to perform on young children because of their small veins and lack of co-operation. On the contrary, angiocardiography is simple and harmless as far as our experience shows. Although the extensive and careful study Taussig made of the clinical and radiological picture of the different congenital heart malformations means a very great aid to diagnosis, we still believe that, especially in infants, angiocardiography can be a great help. At this early age diagnosis is difficult because the heart has not acquired its typical form and the physical and electrocardiographic signs are not yet clearly evident. It is also at this stage that the angiocardiograms are clearest as is illustrated by some of the pictures shown here. Therefore, we consider angiocardiography essential in diagnosing congenital heart diseases in infants, and certainly of great help even if not essential in older children.