Visual understanding of cardiac development: the neural crest's contribution.

Understanding normal and abnormal cardiovascular development is of interest to basic scientists as well as to clinicians taking care of infants with heart defects. This article presents a visual overview of cardiac development. It provides a framework on which to understand how abnormal cardiac development leads to groups of cardiovascular defects requiring clinical care. Human heart development is presented schematically and is correlated with similar points in chick cardiac development. Studying both normal and abnormal cardiac development in neural crest-ablated embryos has highlighted two major themes of cardiac development: there is a mechanism of differential growth in the developing cardiovascular system that is not seen to a major extent after birth and cardiac defects can be pictured as arrested stages of normal development. At a particular stage of development, it is normal to have a certain relationship between developing structures. However, if the development is arrested and this relationship of structures is allowed to persist, it then becomes abnormal. Visualizing heart defects as arrested points in normal development is better used as a tool to categorize defects than as a causative mechanism. The exact mechanisms of how abnormal development results in cardiac defects is not well understood. Study of the neural crest model of cardiac defects suggests possible mechanisms.