Heart disease in childhood: from malformed hearts to the silent impact of unhealthy lifestyles.

Early recognition of congenital heart disease, coupled with the growth and sophistication of diagnostic, medical, and surgical interventions at early ages, has resulted in significantly improved outcomes. However, the cardiovascular impact of the epidemic of childhood obesity and its related disorders now looms as an even greater threat to the health of children.

Racial and geographic disparities in timing of bidirectional Glenn and Fontan stages of single-ventricle palliation.

OBJECTIVE: In adults, race-based disparity in access to cardiovascular care has been documented. Racial differences in cardiac care for children have not been evaluated previously. METHODOLOGY: We analyzed timing of single-ventricle palliation as a function of race and geography at Duke University Medical Center (DUMC) from 1997-2000. RESULTS: African American children underwent bidirectional Glenn (BDG) at a median age of 11 months (13.8 +/- 10.8, n = 11); white children at five months (5.6 +/- 2.3, n = 29), p = 0.01. African American children underwent Fontan at 60 months (106.8 +/- 84.0, n = 9); white children at 36 months (45.6 +/- 36.0, n = 18), p = 0.005. CONCLUSIONS: African American children at DUMC underwent palliation at a later age and with more variability in age than did white children. Further investigation is needed to determine possible causes of these race-associated differences in health care delivery.