|Neonatal 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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