In the December 2025 episode of Critical Decisions in Emergency Medicine, Drs. Danya Khoujah and Wendy Chang discuss pediatric acquired heart defects and savings 101 for physicians. As always, you’ll also hear about the hot topics covered in the regular features, including wide-complex tachycardia in an older adult in The Critical ECG, a child with a vesicular rash in Clinical Pediatrics, distal femur Salter-Harris II fracture in Orthopedics and Trauma, Bartholin cyst drainage in The Critical Procedure, noninvasive respiratory support for acute respiratory failure in The LLSA Literature Review, a patient with a breast mass in The Critical Image, high-potency tetrahydrocannabinol in The Drug Box, and cone snail envenomation in The Tox Box.