The pediatric cardiology's past is mainly concentrated in the last 50 years. It is a story of four questions about the heart.

Although the answers are not answered, we have come close to the answers towards the end of twentieth century and no doubt will even get closer during the present century.

During last fifty years, pediatric cardiology has travelled a lot starting from revelation of anatomy of heart, followed by therapeutic advances, investigative approach, to surgical intervention for malformed heart. During this passage pediatric cardiology's simple problems became complex while complex problems became simple.

As long as practitioners in pediatric cardiology had only binary choices, to do or not to do, meaning to operate or not to operate things were rather simple. But conceptual and technical advances have brought many options. This has resulted in far more complex field of medicine, which requires wide knowledge and expertise as well as more equipment and greater expenses. On the other hand we know now more about pharmacology and pharmacokinetics in neonates, infants and children and more and more drugs are available making it rather easy to treat heart failure, cardiac arrhythmias and cardiomyopathies.

The operative therapeutic doors in congenital heart diseases were really opened with the introduction of oxygenator in 1950. This landmark achievement rendered majority of congenital heart anomalies amenable to some form of corrective or palliative surgical relief. Now it has become imperative to clinically diagnose the anomaly followed by anatomical malformation imaging and physiological hemodynamics studies at the earliest possible moment and try to correct it surgically or by interventional transcatheter manipulations.