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Echocardiography in Pediatric Heart Disease.
  1. M BURCH, Consultant paediatric cardiologist

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    Echocardiography in Pediatric Heart Disease.2nd Ed. By Rebecca Snider, Gerald Serwer, and Samuel Ritter. (Pp 596; £125 hardback.) Mosby, 1997. ISBN 0-8151-7851-4.

    There is no doubt that two dimensional echo has revolutionised the practice of paediatric cardiology. It is a safe, painless, portable technique that can be performed by the bed/cotside. It has largely replaced diagnostic angiography. In North America there are now doctors who are solely paediatric echocardiographers (in the UK we tend to be “Jacks of all trades”, I forget the rest of that aphorism). Three luminary American echocardiographers have produced this fine textbook.

    It is the second edition, the first was published in 1990. Have things changed enough since then to justify a new edition?....... Colour flow Doppler has developed into an essential part of the examination and this alone could justify a major revision, or at least many new pictures and about 50 good quality colour plates are included. New branches of clinical echo work such as fetal and transoesophageal echocardiography, and those largely confined to research (at present) such as three dimensional and intravascular, are included, but these techniques are probably best served by their own texts. The authors have radically changed the chapter on quantitative methods. Interestingly, they state that the need for M mode has been virtually eliminated, which may cause a few waves of apoplexy in the UK, but is probably right.

    The core of this book remains two dimensional imaging in congenital heart disease. I would have liked to see more line drawings of abnormalities as these can be very helpful for trainees. There are many excellent echo pictures in the text. A mentor once told me that a good textbook should have figures you wished to copy for lecture slides and this book passes that test easily. It is almost as comprehensive as an atlas, but not quite; there are enough gaps to make it a little frustrating for use as a dip-in text to help an experienced echocardiographer establish a rare diagnosis, for example a pulmonary sling.

    There is a comprehensive reference section at the end of each chapter, as is the way of major texts, but I wonder if this is really necessary given the easy access to computer searches which will inevitably be more up to date.

    This text is unlikely to be of use to paediatricians. Whether paediatricians should be scanning hearts is much debated. I think they should, but would benefit from a basic course initially, and probably a video instruction (which is something we try to provide in our region), rather than a comprehensive text such as this.

    This book is ideal for new registrars (and perhaps echo technicians) in paediatric cardiology, and I recommend it to them.

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