Symbolic logic analysis of congenital heart disease

In identifying the primary, genetic or environmental event in human cardiac malformations, it is desirable to separate out the apparently secondary lesions. We have employed the general principle that multiple cardiac lesions within a single patient may often represent a pathogenetic process in which one primary event gives rise to a sequence of secondary lesions. The mechanical paradigm of cardiogenesis suggests that abnormal primary lesions may give rise to secondary lesions through altered blood flow or pressure relations, if the secondary structure normally appears later and represents a reasonable tissue response to altered mechanics. Symbolic logic is a mathematical method in which descriptive statements are placed in formal relation to one another and their logical consequences are deduced. Using the mechanical paradigm as a technique of hypothesis generation and symbolic logic as a technique of hypothesis testing, we have analyzed the following malformation complexes in large series of autopsied patients: coarctation of the aorta, tetralogy of Fallot, truncus arterious malformation, interrupted aortic arch, and semilunar valve malformations.