There are a number of commonly encountered acute cardiac presentations in older infants and children that are essential to recognise early in order to institute appropriate emergency care. Many of these will be the first clinical presentation of a child; therefore the attending doctor or nurse, with no specific diagnosis, will need to know the basic physiology of the cardiovascular system and the common derangements that may occur. For children with a known diagnosis, such as the above-mentioned one, attending practitioners must be able to manage life-threatening complications, as these patients will often be seen in a non-tertiary setting. This book, therefore, begins with brief over view of history taking, physical examination, and investigative techniques just as in any other book in discipline of Medicine/cardiology Cardiac arrhythmias in children are not only difficult to diagnose but also to manage these rhythm disturbances with emergent treatment, this book therefore, describes in detail their respective management. The heart failure which is often the terminal event of many congenital and acquired heart disorders is yet another cardiac emergency which attracts physician/cardiologist/cardiac surgeon's attention in emergency department. This subject has been written with utmost care giving details of its recognition, medical and surgical interventions in its management.