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Neonatal Cardiology, 2eNeonatal Cardiology, 2e

Chapter 5. Initial Evaluation of the Newborn with Suspected Cardiovascular Disease

Topics Discussed: congenital heart disease; hypoperfusion in newborn; neonatal cyanosis; neonatal tachypnea; pediatric cardiology.
Sections: History, Family History, Physical Examination, Ancillary Tests, Initial Treatment, Suggested Readings.
Excerpt:"Congenital heart disease occurs in about 1% of live births (excluding bicuspid aortic valve and hemodynamically insignificant lesions such as small atrial and ventricular septal defects). Critical congenital heart disease consists of a group of defects which will result in death or severe morbidity if unrecognized in early infancy. Such defects often depend on patency of the ductus arteriosus to maintain either pulmonary or systemic blood flow. Signs of rapidly progressive heart failure and cardiovascular collapse develop as the ductus arteriosus constricts during the first few days after birth. It is important to recognize that a newborn with critical congenital heart disease may show little evidence of cardiovascular compromise on physical examination in the first 24 to 48 hours of life. Cardiovascular instability may not occur until after the infant is discharged from the hospital. 1. Decreased pulmonary blood flow
2. Normal to increased pulmonary blood flow but with a transposed aorta, for example, simple d-transposition of the great arteries
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