Clinical implications of current research: will understanding etiology lead to prevention?
Sissman, N.J.
Johns Hopkins Medical Journal 140(4): 189-191
1977
ISSN/ISBN: 0021-7263 PMID: 850337 Document Number: 122928
The answer to the question in the title is "yes." With some major qualification of the meaning of "current," there is no doubt that research into the etiology of cardiac malformations will result in the ability to prevent most of them. Although one cannot predict how soon this state of affairs will come about, its inevitability should ease concern, expressed elsewhere, that increasing therapeutic successes will lead to an undesirable increase in the incidence of heart defects. Several paths along which "progress" will lead to the capability of prevention are discussed. First is the ability to diagnose defects before birth. Echocardiography has developed so rapidly that it is easy to accept the proposition that within a decade, or sooner, echoes will be able to locate the fetal heart and be able to define (by the end of the first trimester, and thus early enough to permit safe, convenient therapeutic abortions) abnormalities of size, shape, position and movement of chambers, great vessels and valves. A 2nd mechanism by which the number of infants born with malformed hearts may be reduced is derived from the hypothesis of genetic-environmental interaction, the multifactorial etiology of congenital heart disease. The search for environmental "triggers" is expanding constantly. Whether the future holds the promise of understanding the mechanisms of cardiac morphogenesis so thoroughly that it will be only a matter df time before medical means of selectively altering these can be developed was discussed.