The aim of this chapter is to provide a general overview of cardiac patient management in intensive care. As in other critical care settings, the management of cardiac patients should be focused on optimizing the balance between oxygen delivery and oxygen consumption. In order to achieve this, understanding hemodynamic monitoring and the underlying cardiovascular and respiratory physiology is mandatory. Being familiar with the anatomy and (patho-)physiology of the different types of congenital heart disease (CHD) is also crucial to provide tailored pre- and post-operative support and to be able to anticipate usual complications.