Pediatric Cardiology in Wartime: The Hidden Burden of Delayed Care and the Imperative of Reversibility

Armed conflicts disrupt healthcare systems, creating profound challenges for children with congenital heart disease (CHD). Time is a critical determinant of cardiac physiology, disease progression, and surgical feasibility. This editorial highlights how delays in diagnosis and treatment transform otherwise reversible conditions into advanced, irreversible, and life-limiting disease. Focusing on pulmonary vascular disease in neglected shunt lesions, truncus arteriosus, and left ventricular (LV) deconditioning in D-transposition of the great arteries (D-TGA), we outline the pathophysiological pathways through which delayed intervention limits therapeutic options. We also emphasize the ethical responsibility of the global pediatric cardiology community to develop wartime-resilient care models.