Editing Cardiology (section)

=== Congenital heart defects ===
{{Main|Congenital heart defect}}

A congenital heart defect, also known as a "congenital heart anomaly" or "congenital heart disease", is a problem in the structure of the heart that is present at [[childbirth|birth]].<ref name=NIH2011>{{cite web|title=What Are Congenital Heart Defects?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/chd|website=National Heart, Lung, and Blood Institute|access-date=10 August 2015|date=July 1, 2011}}</ref> Signs and symptoms depend on the specific type of problem.<ref name=WHO2011/> Symptoms can vary from none to life-threatening.<ref name=NIH2011/> When present they may include rapid breathing, [[cyanosis|bluish skin]], poor weight gain, and feeling tired.<ref name=NIH2011Sym-b/> It does not cause chest pain.<ref name=NIH2011Sym-b>{{cite web|title=What Are the Signs and Symptoms of Congenital Heart Defects?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/chd/signs|website=National Heart, Lung, and Blood Institute|access-date=10 August 2015|date=July 1, 2011}}</ref> Most congenital heart problems do not occur with other diseases.<ref name=WHO2011>{{cite book|author1=Shanthi Mendis|author2=Pekka Puska|author3=Bo Norrving|author4=World Health Organization|title=Global Atlas on Cardiovascular Disease Prevention and Control|url=http://whqlibdoc.who.int/publications/2011/9789241564373_eng.pdf?ua=1|year=2011|publisher=World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization|pages=3, 60|isbn=978-92-4-156437-3}}</ref> Complications that can result from heart defects include [[heart failure]].<ref name=NIH2011Sym-b/>

<!-- Cause and diagnosis-->
The cause of a congenital heart defect is often unknown.<ref>{{cite web|title=What Causes Congenital Heart Defects?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/chd/causes|website=National Heart, Lung, and Blood Institute|access-date=10 August 2015|date=July 1, 2011}}</ref> Certain cases may be due to infections during [[pregnancy]] such as [[rubella]], use of certain medications or drugs such as [[ethanol|alcohol]] or [[tobacco]], parents being closely related, or poor nutritional status or [[obesity]] in the mother.<ref name=WHO2011/><ref name=Dean2014>{{cite journal|last1=Dean|first1=SV|last2=Lassi|first2=ZS|last3=Imam|first3=AM|last4=Bhutta|first4=ZA|title=Preconception care: nutritional risks and interventions|journal=Reproductive Health|date=26 September 2014|volume=11|issue=Suppl 3 |pages=S3|pmid=25415364|doi=10.1186/1742-4755-11-s3-s3|pmc=4196560 |doi-access=free }}</ref> Having a parent with a congenital heart defect is also a risk factor.<ref name=Mil2011/> A number of genetic conditions are associated with heart defects including [[Down syndrome]], [[Turner syndrome]], and [[Marfan syndrome]].<ref name=WHO2011/> Congenital heart defects are divided into two main groups: [[cyanotic heart defect]]s and [[non-cyanotic heart defect]]s, depending on whether the child has the potential to turn bluish in color.<ref name=WHO2011/> The problems may involve the interior walls of the heart, the [[heart valves]], or the large blood vessels that lead to and from the heart.<ref name=NIH2011/>

<!-- Prevention and treatment -->
Congenital heart defects are partly preventable through [[rubella vaccination]], the adding of [[iodine]] to salt, and the adding of [[folic acid]] to certain food products.<ref name=WHO2011/> Some defects do not need treatment.<ref name=NIH2011/> Other may be effectively treated with [[catheter procedure|catheter based procedures]] or [[cardiac surgery|heart surgery]].<ref name=NIH2011Tx/> Occasionally a number of operations may be needed.<ref name=NIH2011Tx>{{cite web|title=How Are Congenital Heart Defects Treated?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/chd/treatment|website=National Heart, Lung, and Blood Institute|access-date=10 August 2015|date=July 1, 2011}}</ref> Occasionally [[heart transplantation]] is required.<ref name=NIH2011Tx/> With appropriate treatment outcomes, even with complex problems, are generally good.<ref name=NIH2011/>

<!-- Epidemiology and prognosis -->
Heart defects are the most common [[birth defect]].<ref name=WHO2011/><ref name=GBD2015/> In 2013 they were present in 34.3 million people globally.<ref name="GBD2015">{{cite journal |last1= Vos|first1= Theo|last2= Barber|first2= Ryan M.|last3= Bell|first3= Brad|last4= Bertozzi-Villa|first4= Amelia|last5= Biryukov|first5= Stan|last6= Bolliger|first6= Ian|last7= Charlson|first7= Fiona|last8= Davis|first8= Adrian|last9= Degenhardt|first9= Louisa|last10= Dicker|first10= Daniel|last11= Duan|first11= Leilei|last12= Erskine|first12= Holly|last13= Feigin|first13= Valery L.|last14= Ferrari|first14= Alize J.|last15= Fitzmaurice|first15= Christina|last16= Fleming|first16= Thomas|last17= Graetz|first17= Nicholas|last18= Guinovart|first18= Caterina|last19= Haagsma|first19= Juanita|last20= Hansen|first20= Gillian M.|last21= Hanson|first21= Sarah Wulf|last22= Heuton|first22= Kyle R.|last23= Higashi|first23= Hideki|last24= Kassebaum|first24= Nicholas|last25= Kyu|first25= Hmwe|last26= Laurie|first26= Evan|last27= Liang|first27= Xiofeng|last28= Lofgren|first28= Katherine|last29= Lozano|first29= Rafael|last30= MacIntyre|first30= Michael F.|display-authors= 1|date=7 June 2015 |title=Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 |journal=Lancet |volume=386 |issue=9995 |pages=743–800 |doi=10.1016/S0140-6736(15)60692-4 |pmc=4561509 |pmid=26063472}}</ref> They affect between 4 and 75 per 1,000 live births depending upon how they are diagnosed.<ref name=WHO2011/><ref name=Mil2011>{{cite book|last1=Milunsky|first1=Aubrey|title=Genetic Disorders and the Fetus: Diagnosis, Prevention and Treatment|date=2011|publisher=John Wiley & Sons|isbn=9781444358216|chapter-url=https://books.google.com/books?id=yY-gIvbnRDUC&pg=PT28|chapter=1}}</ref> About 6 to 19 per 1,000 cause a moderate to severe degree of problems.<ref name=Mil2011/> Congenital heart defects are the leading cause of birth defect-related deaths.<ref name=WHO2011/> In 2013 they resulted in 323,000 deaths down from 366,000 deaths in 1990.<ref name="pmid25530442"/>

==== Tetralogy of Fallot ====
[[Tetralogy of Fallot]] is the most common congenital heart disease arising in 1–3 cases per 1,000 births. The cause of this defect is a [[ventricular septal defect]] (VSD) and an [[overriding aorta]]. These two defects combined causes deoxygenated blood to bypass the lungs and going right back into the circulatory system. The [[modified Blalock-Taussig shunt]] is usually used to fix the circulation. This procedure is done by placing a graft between the subclavian artery and the ipsilateral pulmonary artery to restore the correct blood flow.

==== Pulmonary atresia ====
[[Pulmonary atresia]] happens in 7–8 per 100,000 births and is characterized by the aorta branching out of the right ventricle. This causes the deoxygenated blood to bypass the lungs and enter the circulatory system. Surgeries can fix this by redirecting the aorta and fixing the right ventricle and pulmonary artery connection.

There are two types of pulmonary atresia, classified by whether or not the baby also has a [[ventricular septal defect]].<ref name="Medscape2015">{{cite web |url=https://emedicine.medscape.com/article/892980-overview |title=Ventricular Septal Defects: Background, Anatomy, Pathophysiology |vauthors = Ramaswamy P, Webber HS|website=Medscape |publisher=WebMD LLC |access-date=August 22, 2017 }}</ref><ref name=":0">{{cite web |url=https://www.cdc.gov/ncbddd/heartdefects/pulmonaryatresia.html |title=Facts about Pulmonary Atresia: Types of Pulmonary Atresia|author=<!--Not stated--> |website=CDC |publisher=USA.gov |access-date=August 22, 2017 }}</ref>
* Pulmonary atresia with an intact ventricular septum: This type of pulmonary atresia is associated with complete and intact [[septum]] between the ventricles.<ref name=":0" />
* Pulmonary atresia with a ventricular septal defect: This type of pulmonary atresia happens when a ventricular septal defect allows blood to flow into and out of the right ventricle.<ref name=":0" />

==== Double outlet right ventricle ====
[[Double outlet right ventricle]] (DORV) is when both great arteries, the pulmonary artery and the aorta, are connected to the right ventricle. There is usually a VSD in different particular places depending on the variations of DORV, typically 50% are subaortic and 30%. The surgeries that can be done to fix this defect can vary due to the different physiology and blood flow in the defected heart. One way it can be cured is by a VSD closure and placing conduits to restart the blood flow between the left ventricle and the aorta and between the right ventricle and the pulmonary artery. Another way is systemic-to-pulmonary artery shunt in cases associated with [[Pulmonic stenosis|pulmonary stenosis]]. Also, a [[Atrial septostomy|balloon atrial septostomy]] can be done to relieve hypoxemia caused by DORV with the Taussig-Bing anomaly while surgical correction is awaited.<ref>{{Cite journal |last=Rao |first=P. Syamasundar |date=2019-04-04 |title=Management of Congenital Heart Disease: State of the Art—Part II—Cyanotic Heart Defects |journal=Children |volume=6 |issue=4 |pages=54 |doi=10.3390/children6040054 |issn=2227-9067 |pmc=6518252 |pmid=30987364|doi-access=free }}</ref>

==== Transposition of great arteries ====
[[File:D-tga-575px.jpg|thumb|Dextro-transposition of the Great Arteries]]
There are two different types of [[Transposition of the great vessels|transposition of the great arteries]], [[Dextro-Transposition of the great arteries|Dextro-transposition of the great arteries]] and [[Levo-Transposition of the great arteries|Levo-transposition of the great arteries]], depending on where the chambers and vessels connect. Dextro-transposition happens in about 1 in 4,000 newborns and is when the right ventricle pumps blood into the aorta and deoxygenated blood enters the bloodstream. The temporary procedure is to create an [[atrial septal defect]]. A permanent fix is more complicated and involves redirecting the pulmonary return to the right atrium and the systemic return to the left atrium, which is known as the [[Senning procedure]]. The [[Rastelli procedure]] can also be done by rerouting the left ventricular outflow, dividing the pulmonary trunk, and placing a conduit in between the right ventricle and pulmonary trunk. Levo-transposition happens in about 1 in 13,000 newborns and is characterized by the left ventricle pumping blood into the lungs and the right ventricle pumping the blood into the aorta. This may not produce problems at the beginning, but will eventually due to the different pressures each ventricle uses to pump blood. Switching the left ventricle to be the systemic ventricle and the right ventricle to pump blood into the pulmonary artery can repair levo-transposition.{{citation needed|date=April 2021}}

==== Persistent truncus arteriosus ====
[[Persistent truncus arteriosus]] is when the [[truncus arteriosus]] fails to split into the aorta and pulmonary trunk. This occurs in about 1 in 11,000 live births and allows both oxygenated and deoxygenated blood into the body. The repair consists of a VSD closure and the Rastelli procedure.<ref>{{Cite web |title=Persistent Truncus Arteriosus – Pediatrics |url=https://www.msdmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/persistent-truncus-arteriosus |access-date=2022-06-19 |website=MSD Manual Professional Edition |language=en}}</ref><ref>{{Cite web |last=Cleveland Clinic |date=September 17, 2021 |title=Truncus Arteriosus |url=https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus |url-status=live |website=[[Cleveland Clinic]]|archive-url=https://web.archive.org/web/20200804222430/https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus |archive-date=2020-08-04 }}</ref>

==== Ebstein anomaly ====
[[Ebstein's anomaly]] is characterized by a right atrium that is significantly enlarged and a heart that is shaped like a box. This is very rare and happens in less than 1% of congenital heart disease cases. The surgical repair varies depending on the severity of the disease.<ref>{{Cite journal|last=Bhat|first=Venkatraman|title=Illustrated Imaging Essay on Congenital Heart Diseases: Multimodality Approach Part III: Cyanotic Heart Diseases and Complex Congenital Anomalies|journal=Journal of Clinical and Diagnostic Research|doi=10.7860/jcdr/2016/21443.8210|pmc=5020285|pmid=27630924|volume=10|issue=7|year=2016|pages=TE01–10}}</ref>

Pediatric cardiology is a sub-specialty of [[pediatrics]]. To become a pediatric cardiologist in the U.S., one must complete a three-year residency in pediatrics, followed by a three-year fellowship in pediatric cardiology. Per [[doximity]], pediatric cardiologists make an average of $303,917 in the U.S.<ref name="r1" />