Detection of congenital heart disease (CHD) remains the main focus in the screening of childhood cardiac conditions. History taking and physical examination form the backbone of this screening process. Referral to a paediatric cardiologist is required for diagnosis and management. There is a need to understand which referrals are urgent. Increasingly, the primary care clinician will encounter the growing pool of post-operative CHD and will need to be familiar with the potential morbidities of this group. Kawasaki Disease is the most common acquired childhood cardiac condition. There should be a high index of suspicion in a child with prolonged fever and a constellation of rash, conjunctivitis, mucositis, dactylitis and cervical lymphadenopathy. Timely diagnosis and treatment prevent coronary artery complications. The primary care physician should also be on the alert to recognise children with cardiac arrhythmias, acute myocarditis, cardiomyopathies and valvular heart disease. Other rare conditions include idiopathic pulmonary arterial hypertension. Screening for risk factors for sudden cardiac death may also be important, particularly for children involved in competitive sports. Primary prevention of coronary artery disease and metabolic syndrome starts in childhood. The “at-risk” child should be identified early and healthy lifestyle and diet promoted.

Right ventricle to pulmonary artery (RV-PA) conduits have been used for the surgical repair of congenital heart defects. These conduits frequently become stenosed or develop insufficiency with time, necessitating reoperations. Percutanous pulmonary valve implantation (PPVI) can delay the need for repeated surgeries in patients with congenital heart defects and degenerated RV-PA conduits. We presented our first experience with PPVI and described in detail the procedural methods and the considerations that are needed for this intervention to be successful. Immediate and short-term clinical outcomes of our patients were reported. Good haemodynamic results were obtained, both angiographically and on echocardiography. PPVI provides an excellent alternative to repeat open-heart surgery for patients with congenital heart defects and degenerated RV-PA conduits. This represents a paradigm shift in the management of congenital heart disease, which is traditionally managed by open-heart surgery.