Congenital Heart Defect

This document summarizes causes, symptoms, and management of cyanosis in newborns.

This document relates to the acute management of infants presenting acutely with collapse and/or cyanosis suggestive of congenital heart defect.

Objective: To assess the performance of pulse oximetry as a screening method for the detection of critical congenital heart defects in asymptomatic newborn babies.

Objective: This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease.

Objective: This article presents an approach for identification of infants with congenital heart disorders.

Objective: To review our experience of a low initial dose of PGE1 treatment in early newborns with congenital heart disease and patent ductus arteriosus (PDA)-dependent pulmonary flow.

This publication provides an overview of the presentations of congenital heart defects, and makes diagnosis and management recommendations for emergency physicians.

Objective: To determine the effect of average SpO(2) range and oxygen administration during neonatal transport on clinical markers of cardiovascular instability.

Objective: To give a general picture of the diagnostic approach to a multitude of heart defects.

This document describes the pretransport and transport management of infants receiving prostaglandin E(1) infusion for congenital heart disease and compares transport complications among unintubated and electively intubated infants.

Objective: To address the evaluation and management of pediatric patients with congenital heart defects in the context of the evidence available from the medical literature.

This study presents the results of an evaluation of transporting, by a nonspecialized emergency medical service, neonates with known or suspected cardiac abnormalities.

This document discusses the potential challenges in recognizing cyanosis, including the presence of higher concentrations of fetal hemoglobin, and its oxygen binding characteristics.

Objective: To evaluate the safety of transporting newborn infants with suspected duct dependent congenital heart disease (CHD) treated with prostaglandin E1 (PGE1) without routine mechanical ventilation.

This document discusses the most common causes of cyanotic and acyanotic heart disease in infants.

General clinicians and junior paediatricians may have little experience of interpreting paediatric electrocardiograms. Although the basic principles of cardiac conduction and depolarisation are the same as for adults, age related changes in the anatomy and physiology of infants and children produce normal ranges for electrocardiographic features that differ from adults and vary with age. Awareness of these differences is the key to correct interpretation of paediatric electrocardiograms.

This document addresses some of the principles on which resuscitation and stabilisation of the symptomatic neonate with congenital heart disease may be based.

Objective: To determine the prevalence and clinical significance of murmurs detected during routine neonatal examination.

This retrospective review of critically ill infants 0 to 28 days of age presenting with either bacterial sepsis or meningitis or a congenital obstructive left heart syndrome (COLHS), identifies historical, physical, or laboratory findings which might differentiate the two groups at presentation.

This study reports experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD).

Learning Objectives

1. To develop a simple approach to CHD using age, colour and bedside tests
2. To understand how the hyperoxia test and 4 limb BP narrow the differential diagnosis

Learning Objectives

1. Investigations for congenital heart disease emergencies
2. Management of congenital heart disease emergencies

Best Case Ever #48: In anticipation of EM Cases’ upcoming episode, Congenital Heart Disease Emergencies, Dr. Gary Joubert discusses his Best Case Ever of a four month old infant who presents with intermittent cyanosis. The Cyanotic Infant can present a significant challenge to the EM provider as the differential is wide, ranging from benign causes such as GERD to life threatening heart disease that may present atypically in a well-appearing child. Dr. Joubert provides some simple clinical pearls to help ED providers along the way. Published online: July 2016. 

Episode 84: You might be surprised to learn that the prevalence of critical cardiac disease in infants is almost as high as the prevalence of infant sepsis. Critical congenital heart defects are often missed in the ED. For a variety of reasons, there are currently more children with congenital heart disease presenting to the ED than ever before and these numbers will continue to grow in the future. With the goal of learning a practical approach to congenital heart disease emergencies using the child’s age, colour and few simple tests, Dr. Strobel and Dr. Joubert will discuss some key actions, pearls and pitfalls so that the next time you’re faced with that crashing baby in the resuscitation room, you’ll know exactly what to do. This podcast topic was chosen based on a Canada-wide needs assessment by TREKK – translating emergency knowledge for kids. 

Published online: August 2016.