Congenital Diseases of the Heart

Abstract

Congenital diseases of the heart have always excited the interest of clinicians because the mechanical defects produced by them throw light on many of the problems of acquired heart disease. In the nineteenth century acquired heart disease was extraordinarily prevalent and was responsible for a much higher mortality than any other disease; as a result, congenital anomalies were only studied in so far as they were helpful in solving the mechanical problems of acquired lesions. Until the beginning of the present century congenital heart lesions were always regarded gloomily, but then it was recognised that many of them were by no means inconsistent with normal life and that in many of them life could be prolonged by suitable therapy and careful supervision. Recognition of these facts led to an intensive study of congenital diseases for their own sake, and in this study radiology is slowly but surely playing a part. Unlike the study of diseases of the lungs and gastro-intestinal tract, where an X-ray examination is often the deciding factor in diagnosis, radiology in heart disease can never be more than supplementary to clinical and electrocardiographic methods. We see by X rays only the changes in outline of the heart wrought by changes in pressure. The blood pressure, the pulse, the condition of the vessels, and secondary changes in other organs are all more important than an X-ray examination. With a few exceptions this applies just as much to congenital heart lesions as to acquired ones.