 Introduction/Background Congenital and acquired pediatric heart disease is a large and diverse field with an overall prevalence estimated at 6 to 13 per 1,000 live births [1,2]. Congenital heart disease (CHD) can be broadly divided into acyanotic and cyanotic conditions. The 3 most common conditions are all acyanotic; bicuspid aortic valve, ventricular septal defects (VSD), and atrial septal defects. Common acquired cardiovascular conditions in children include aortopathy, cardiomyopathy, myocarditis, and vasculitis. Advanced imaging plays an important complementary role to transthoracic echocardiography (TTE) in the initial evaluation of congenital and acquired cardiovascular disease in children. Advances in treatment [2,3] have resulted in much longer survival of patients with CHD [4]. This longer survival has resulted in postsurgical patients often requiring imaging follow-up to look for secondary complications of corrective procedures like ventricular dysfunction, valvular dysfunction, and secondary vascular compromise. This document covers variants representing some of the most common indications for advanced imaging of childhood onset cardiovascular disease. All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Congenital or Acquired Heart Disease
Congenital or Acquired Heart Disease.  Introduction/Background Congenital and acquired pediatric heart disease is a large and diverse field with an overall prevalence estimated at 6 to 13 per 1,000 live births [1,2]. Congenital heart disease (CHD) can be broadly divided into acyanotic and cyanotic conditions. The 3 most common conditions are all acyanotic; bicuspid aortic valve, ventricular septal defects (VSD), and atrial septal defects. Common acquired cardiovascular conditions in children include aortopathy, cardiomyopathy, myocarditis, and vasculitis. Advanced imaging plays an important complementary role to transthoracic echocardiography (TTE) in the initial evaluation of congenital and acquired cardiovascular disease in children. Advances in treatment [2,3] have resulted in much longer survival of patients with CHD [4]. This longer survival has resulted in postsurgical patients often requiring imaging follow-up to look for secondary complications of corrective procedures like ventricular dysfunction, valvular dysfunction, and secondary vascular compromise. This document covers variants representing some of the most common indications for advanced imaging of childhood onset cardiovascular disease. All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Congenital or Acquired Heart Disease