In 2000, congenital anomalies accounted for 14.5% of deaths among children under 5 years of age, ranking fourth, with urban areas accounting for 24.6% (second only to neonatal diseases) and rural areas accounting for 14.5%. 14.5%. This shows that birth defects have gradually become one of the major public health problems in China. Congenital heart disease (congenital heart disease) is one of the most common congenital birth defects in children, and the incidence of congenital cardiovascular disease in the United States is reported to be 8.1 ‰. have different types of congenital heart disease. According to our birth defect monitoring results, the incidence of congenital heart disease in China has a significant upward trend, with a national rate of 6.51/ million in 1996 and 11.40/ million in 2000. It may be related to the environmental pollution or/and the improvement of medical diagnosis technology and level. What is congenital heart disease? The human heart chambers are divided into four parts, consisting of the right and left atria and the right and left ventricles. The atrial and ventricular septum, as the name implies, is the tissue separating the right and left atria and ventricles. Under normal circumstances, it is like a plate that separates the two atria and ventricles so that the venous blood in the right ventricle does not mix with the arterial blood that passes through the lung tissue after gas exchange. In the fourth week of pregnancy, the fetal heart can already distinguish the atria and ventricles, but at this time the atria and ventricles are common chambers, and after the fourth week until the eighth week, the separation between the chambers gradually forms, separating the two chambers into a four-chambered heart. If, for any reason, the development of the internal structures of the heart is halted, confused or fails to degenerate after birth, defects (commonly known as “holes”), abnormal connections between parts, dysplasia, atresia or abnormal channels can form in the heart, which is called congenital heart disease. After birth, the most common congenital cardiovascular malformations are ventricular septal defect (ventricular defect), atrial septal defect (atrial defect), and arteriovenous ductus arteriosus in second place, followed by simple pulmonary stenosis, tetralogy of Fallot, aortic stenosis, and aortic constriction. There are single and compound malformations of congenital heart disease; and either single or compound malformations can be divided into two categories with skin and purple lips and without skin and purple lips, called cyanotic and non-cyanotic. All these malformations can cause heart enlargement, cardiac hypertrophy, systemic hypoxia, heart failure, cerebrovascular embolism and other complications, and finally lead to death. How can they cause precordial disease? The main causes of precardiac disease can be divided into two categories: genetic and environmental. Genetic factors alone (such as genetic mutations and chromosomal aberrations) account for 8% of cases, environmental factors alone account for 2%, and genetic and environmental factors interact to cause 90% of cases. Environmental factors include mother’s cold, rubella, coxsackie virus infection during the first 3 months of pregnancy, lithium intake, diabetes, alcohol abuse, excessive radiation exposure, and the use of drugs such as amphetamines in early pregnancy without knowing that she is pregnant, or the use of certain drugs such as progesterone in early pregnancy for preterm abortion. Therefore, if there are patients with precardiac disease in the family, mothers with respiratory infections in early pregnancy, diabetes during pregnancy, alcohol consumption, radiation exposure, and improper medication during pregnancy, etc., they should pay high attention and be alert. Therefore, to prevent the occurrence of precardiac disease, patients with diabetes, epilepsy and other diseases should decide on the time of marriage and pregnancy under the guidance of a doctor; the wife should increase nutrition appropriately before pregnancy and strengthen physical exercise to enhance resistance to disease; both husband and wife should quit smoking and drinking before pregnancy; those who are exposed to radiation for a long time or receive radiation treatment should get out of radiation for six months before pregnancy. Women who are frequently exposed to various pesticides and chemical drugs should strengthen protective measures, not use or use less tetracycline, sulfonamide and hormonal drugs, and not use cosmetics containing hormones. At the same time, mothers-to-be should pay attention to the prevention of colds during pregnancy (especially in the early stages of pregnancy), ensure a proper and reasonable diet structure, avoid X-ray examinations, use less radiation-bearing equipment such as computers, and do not take medication indiscriminately. When should a child be alerted to this disease? The majority of children are found to have a heart murmur during a visit for upper respiratory flu or pneumonia or during a routine physical examination. However, some babies are born with a heart murmur that is not heard by the doctor and is only detected at an early stage when the baby is examined at full term or later. Moreover, some children can hear a heart murmur, but there is no heart disease, this murmur is called “functional murmur”, this murmur is easy to change, sometimes very light, sometimes more obvious, and sometimes even disappear. It is usually more pronounced when the child has a fever, cries, exercises vigorously, or lies down, and it diminishes after the fever subsides, when the child is quiet, or when the child sits up. So a child with a heart murmur does not necessarily mean heart disease, let alone congenital heart disease, and parents should not be nervous, and should be reviewed regularly. However, parents should be alert to congenital heart disease when they find the following manifestations in their children: 1, frequent colds, recurrent bronchitis, pneumonia. 2, feeding difficulties or infants refuse to eat, choking and coughing, often eating and stopping, shortness of breath, pale face, breath-holding, etc. 3.The skin is continuously cyanotic, most obvious at the tip of the nose, lips of the mouth and finger (toe) nail beds. 4.Children who can walk often crouch down voluntarily for a moment while walking or playing (crouching phenomenon). 5. Older children have thickened and darkened finger and toe ends. 6.Children complain of easy fatigue, poor stamina, plain sweating, perioral bruising, and hemoptysis. 7, abnormal development, manifesting as thinness, malnutrition, growth retardation, etc. 8, the child appears chest pain, syncope. What should I do if my child has precordial disease? Precardiac disease is usually diagnosed by electrocardiogram, cardiac X-ray, color Doppler echocardiography and other tests, and some patients need to undergo further tests such as cardiac catheterization to confirm the diagnosis. Therefore, when a child is suspected of having a precocious heart disease, he or she should first see a pediatric cardiovascular specialist as soon as possible to learn more about the type, location and severity of the heart malformation through physical examination and necessary special tests, and to select the appropriate age for surgery. Some data show that half of the untreated cases of precordial disease die by the age of one and two-thirds by the age of two. And the more complex the malformation, the more severe the disease the more death and the earlier death. The disease progresses rapidly in infancy and early childhood, and cases with left-to-right shunts, such as ventricular septal defects, are prone to complications of pulmonary hypertension. When the complication is mild to moderate pulmonary hypertension, surgical treatment can still be sought, but when it progresses to severe pulmonary hypertension, the opportunity for surgery is lost and one has to wait for a heart-lung transplant, but unfortunately, transplant donors are often difficult to find and almost all die within forty years of age. Therefore, early detection, early diagnosis and early treatment are the keys to reduce the natural and operative mortality of precocious heart disease and to improve the effectiveness of surgical treatment. However, some precordial diseases such as small atrial and ventricular defects, especially perimembranous ventricular defects, can close on their own in about 40% of cases in infancy (0-3 years old), and 60% have closed on their own by the age of 5 years. This is related to the location and size of the ventricular defect and the age of the child. Membranous defects with a defect less than 0.5 cm have the greatest likelihood of closure, and small muscular defects may also close spontaneously. Some membranous ventricular defects may also be reduced in size due to attachment of fibrous tissue around them. Currently, it is thought that children older than 4 years of age are less likely to have a ventricular septal defect close spontaneously, but one case of spontaneous closure at age 46 has been reported in the literature. Due to advances in medical science and technology, the vast majority of congenital heart diseases can be completely cured by surgery and can live and work like normal people after surgery. At present, the success rate of surgical treatment for congenital heart disease in infants and children is over 90 percent. Xinhua Hospital affiliated with Shanghai Jiaotong University Medical College was the first to carry out the diagnosis and treatment of congenital heart disease in China as early as in the 1970s. It has trained the diagnosis and treatment team of congenital heart disease for more than a dozen units in China (such as Beijing Children’s Hospital, Zhejiang Children’s Hospital, Nanjing Children’s Hospital, etc.), and has already played an important role in the field of diagnosis and treatment of congenital heart disease in China. Does every child with congenital heart disease that needs treatment need open-heart surgery? No, it is not. Although the technology of surgical treatment of precocious heart disease has made great progress, many children have been treated in time, but the surgery requires open-heart surgery and the heart needs to stop during the operation and be temporarily replaced by artificial heart and lung machines, and the long time of artificial extracorporeal circulation has certain damage to many important organs, and there are various complications after the operation itself and blood transfusion, certain mortality and cosmetic problems brought about by the surgery This has prompted medical practitioners to seek and explore non-open-heart routes, namely transcatheter intervention (i.e., after peripheral vascular puncture, a plugging or dilating device is delivered into the heart or blood vessels along the cardiac catheter for blocking or dilating treatment). With the continuous maturation of this technology, some of the precordial diseases can be treated by cardiac catheter intervention, which has replaced surgical open-heart surgery. It is mainly used for apical (myocardial) ventricular defects, perimembranous ventricular defects, atrial septal defects, patent ductus arteriosus, pulmonary stenosis, aortic stenosis, etc., which meet some of the indications. However, surgery is still required for children who are not eligible for transcatheter intervention. How can parents take care of their children with precardiac disease before surgery? A reasonable living regime should be arranged for the child, both to enhance exercise and improve the body’s resistance, and to rest properly to avoid overwork. If the child is competent, he or she should try to live and study with normal children, but should prevent strenuous activities. At the same time, children should be educated to have confidence in treating the disease and to reduce pessimism and fear. Children with precocious heart disease are prone to respiratory infections and heart failure, so they should increase and decrease their clothing in time with the change of seasons, take them to public places as little as possible, and actively control infections when they occur. For children with cyanosis, avoid high room temperature, which may cause sweating and dehydration. Give a high protein, high calorie, vitamin-rich diet, avoid overfeeding, and keep the bowels open. Feed the infant with a dropper to reduce physical exertion. Try not to make the child cry and reduce unnecessary stimulation so as not to increase the burden on the heart. It is important to note that children with prediabetes should receive vaccinations on time whenever possible. For parents, once a child is diagnosed with precocious heart disease, regular hospital follow-up is crucial. Echocardiography not only reflects the changes in cardiac function of precocious heart disease in a timely manner, but also allows for timely treatment timing and treatment planning, which plays a key role in the future growth and development of the child.