Background: Congenital heart defects (CHDs) are the most common birth defects globally. CHD often requires specialized care for survival. However, healthcare inequities in pediatric cardiology limit access to prompt diagnostic and holistic therapeutic interventions in low-income families. Case Presentation: We explore two critical CHDs, tetralogy of Fallot (TOF) and transposition of great arteries (TGA), highlighting the intersection of financial limitations, inadequate infrastructure, and suboptimal care. Despite accurate diagnoses and planned interventions, the cases reveal systemic barriers to equitable pediatric cardiac care. Clinical Discussion: Both cases demonstrate the intersection between critical CHD presentations and socioeconomic barriers that exacerbate health inequities. Delayed or missed surgical repairs contribute to morbidity and mortality, while reliance on occasional outreach missions is insufficient to meet the growing need. Conclusion: Addressing health inequities in CHD management demands systemic reforms, local capacity improvement, and international collaboration to prioritize pediatric cardiology in developing countries.
