Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management

  • Lee, Jae-Young (Department of Pediatrics, College of Medicine, the Catholic University of Korea)
  • Received : 2010.05.07
  • Accepted : 2010.05.17
  • Published : 2010.06.15
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Abstract

The risk of mortality and morbidity of patients with congenital heart defects (CHDs) is highest during neonatal period and increases when diagnosis and proper management are delayed. Neonates with critical CHDs may present with severe cyanosis, respiratory distress, shock, or collapse, all of which are also frequent clinical presentations of various respiratory problems or sepsis in the newborn. Early diagnosis and stabilization and timely referral to a tertiary cardiac center are crucial to improve the outcomes in neonates with CHDs. In this review, the clinical presentation of critical and potentially life-threatening CHDs is discussed along with brief case reviews to help understand the hemodynamics of these defects and ensure proper decision-making in critically ill patients.

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References

  1. Wren C, Reinhardt Z, Khawaja K. Twenty-year trends in diagnosis of life-threatening neonatal cardiovascular malformations. Arch Dis Child Fetal Neonatal Ed 2008; 93:F33-5. https://doi.org/10.1136/adc.2007.119032
  2. Hoffman JI, Christianson R. Congenital heart disease in a cohort of 19,502 births with long-term follow-up. Am J Cardiol 1978; 42:641. https://doi.org/10.1016/0002-9149(78)90635-5
  3. Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, Haase N, et al. Heart disease and stroke statistics - 2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2007;115:e69-171. https://doi.org/10.1161/CIRCULATIONAHA.106.179918
  4. Abu-Harb M, Hey E, Wren C. Death in infancy from unrecognised congenital heart disease. Arch Dis Child 1994;71:3-7. https://doi.org/10.1136/adc.71.1.3
  5. Marino BS, Bird GL, Wernovsky G. Diagnosis and management of the newborn with suspected congenital heart disease. Clin Perinatol 2001;28:91-136. https://doi.org/10.1016/S0095-5108(05)70071-3
  6. Pickert CB, Moss MM, Fiser DH. Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant. Pediatr Emerg Care 1998;14:263-7. https://doi.org/10.1097/00006565-199808000-00005
  7. Karimova A, Brown K, Ridout D, Beierlein W, Cassidy J, Smith J, et al. Neonatal extracorporeal membrane oxygenation: practice patterns and predictors of outcome in the UK. Arch Dis Child Fetal Neonatal Ed 2009;94:F129-32. https://doi.org/10.1136/adc.2008.141051
  8. Almeida-Filho OC, Schmidt A, Marin-Neto JA, Maciel BC. Functional pulmonary atresia in a newborn with normal intracardiac anatomy. Pediatr Cardiol 2002;23:647-9. https://doi.org/10.1007/s00246-001-0080-5
  9. Boon R, Hruda J, Schoof PH. Repair of ruptured tendinous chords in the newborn with flail tricuspid valve and functional pulmonary atresia. Int J Cardiol 2007;116:e78-9. https://doi.org/10.1016/j.ijcard.2006.07.231
  10. Wald RM, Adatia I, Van Arsdell GS, Hornberger LK. Relation of limiting ductal patency to survival in neonatal Ebstein's anomaly. Am J Cardiol 2005;96:851-6. https://doi.org/10.1016/j.amjcard.2005.05.035
  11. Chang RK, Gurvitz M, Rodriguez S. Missed diagnosis of critical congenital heart disease. Arch Pediatr Adolesc Med 2008;162:969-74. https://doi.org/10.1001/archpedi.162.10.969
  12. Schultz AH, Localio AR, Clark BJ, Ravishankar C, Videon N, Kimmel SE. Epidemiologic features of the presentation of critical congenital heart disease: implications for screening. Pediatrics 2008;121:751-7. https://doi.org/10.1542/peds.2007-0421

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