ABSTRACT
The management of the infant or child with significant heart disease has largely become the remit of the specialist paediatric cardiologist. The general paediatrician must be able to recognize that a cardiac defect is present and understand its possible consequences in order to make an appropriate and timely referral to the specialist cardiologist. To do this it is necessary to have knowledge of common defects and understand their haemodynamic effects. These will determine the presenting features and the urgency of treatment or referral, which is of particular importance in the neonatal period where rapid deterioration can occur and the initiation of appropriate therapy and transfer to a cardiac centre can be life saving.
