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[Music] hi thanks for joining us my name is jack reitrick and im a pediatric cardiologist at the childrens hospital of philadelphia welcome to pediatric and congenital heart talks a series of lecture presentations and discussions on interesting and important topics in our field of pediatric and congenital heart care in this series we will share insights on a variety of topics offer new perspectives on some basic principles introduce novel concepts and innovations as well as identify what needs to come next to solve challenging problems in our field our objectives are to provide education on a variety of topics but also perhaps to stimulate some provocative thought wed love to hear from you and get your questions and ideas and thoughts on these discussions you can contact us at this email address chop heart talks at email.chop.edu okay lets go ahead and get started [Music] of all the different domains of cardiovascular clinical interest heart failure is one that is quite primary wh