This reference text is a second edition of the version published in 1987. The list of editors and contributors has been updated and expanded to cope with the considerable evolution of diagnosis and treatment of cardiac disease as seen in children, and congenital cardiac malformations in general, in the fifteen years since the first edition. The updated text along with, generally, the highest standard of illustrations has produced a very comprehensive, modern reference text that differs from many reference books by being so very readable. It is no mean feat to coordinate a textbook containing chapters written by numerous eminent authors to be so up to date in all but the most recent developments in the fastest moving areas.

Amongst the particular highlights are the sections on anatomy and embryology, with quite superb photographs, particularly the spectacular scanning electron microscopy, accompanied by line drawings of equal precision; the beautifully illustrated chapter on the pulmonary circulation; and probably the most intelligible chapter on aetiology of congenital cardiac malformations to be found in any textbook to date. The authors of the section on the electrocardiogram and arrhythmias are surely the masters of making the interpretation of electrocardiographic tracings seem simple – this part of the book should be compulsory reading for paediatricians as well as for cardiologists. Similarly, the clear explanation of ventricular function and its intricacies is relevant to every clinician dealing with congenital or acquired myocardial abnormalities. The reader who forgets how closely the lungs are related to the heart is put firmly in his place in the excellent section on lung function, although for those such as myself who struggle more with new science as we get older, a more basic explanation of modern cardiopulmonary exercise testing and its interpretation would have been appreciated. Magnetic resonance is explained very clearly, with some excellent illustrations, leaving one frustrated that the printed medium is incapable of showing the wonderful three dimensional images these authors show when they lecture with the aid of computer presentation. Perhaps printed textbooks are in their last throes for specialties like ours? I can't help but wonder how much more vision of the real present and future of imaging of the heart from the embryo to the adult with congenital cardiac disease would be possible were this textbook in electronic format, together with moving, three-dimensional reconstructions. Something for the third edition to address, perhaps?

Towards the end of the first volume the emphasis changes to focus on specific cardiac lesions. The very clear chapter on isomerism of the atrial appendages would have been even better had more of the echocardiograms been updated from the first edition. It is hard to criticise the generally excellent chapters in this part of the book – anomalies of venous connections, where echocardiography images could again have been updated a little more, atrioventricular connections, ventricles, ventriculoarterial connections, and great arteries all dealt with concisely and in a logical manner. The chapter on tetralogy of Fallot is particularly sound, although perhaps missing a little in controversial aspects such as the place of therapeutic catheterisation, and the still controversial aspect of optimal timing of surgery. The authoritative chapter on coronary arterial anomalies and arteriovenous malformations is followed by an excellent contemporary review of Kawasaki disease, and a solid piece on vascular rings. With the anticipated difficulties in providing really clear echocardiographic images of vascular rings, however, are we alone in Leeds in preferring angiography in these cases? The chapter on coarctation is also excellent, missing out only the latest controversies over implantation of stents.

The later sections of the book deal with general cardiac disease in children, with clear approaches to rheumatic and non-rheumatic heart disease, endocarditis, systemic diseases that affect the heart, hypertension, and tropical diseases. The finale consists of an overview of cardiovascular risk factors in childhood, the management of congenital cardiac disease in pregnancy, congenital heart disease as seen in adolescents and adults, and the psychological, social and ethical aspects of cardiac disease in the young.

Given the limitations of the traditional printed textbook, it is hard to see how this tome could serve its purpose much better. On reflection, I have only one real negative criticism. The publishers have tried to save money by separating the images provided in colour from the grey-scale images. This is very disruptive for the reader, and is an ill advised economy for any publisher. I have previously complained to Churchill Livingstone about their parsimonious and detrimental attitude to colour illustrations, but sadly to no effect. There is little doubt that most readers would be happy to pay a little more to see the colour plates in their logical places in each chapter.

It is always hard work reviewing such a large text, but I enjoyed reading it, and almost all of it really is eminently readable. I can't see how any respectable cardiac department, be it dealing with adults or children, or, indeed, any general paediatric department, could be without a copy of it. This book really is good value for money. For a good deal less than the price of a modest case of Brunello, you can be the owner of this excellent text. If you can afford only the Brunello or the book, you should buy the book – it will last longer. If you can afford both, I can guarantee that the two do go rather well together!