Makindo Medical Notes.com

General Issues

• Central Cyanosis: is due to a failure to oxygenate blood in the pulmonary circulation. Defects allow blood to bypass the lungs or involve severe obstruction to pulmonary blood flow. Infants often present with central cyanosis, which is evident shortly after birth or during episodes of crying or feeding. The degree of cyanosis can vary depending on the severity of the defect and the balance between pulmonary and systemic blood flow. Early detection is crucial.
• Pulse oximetry: screening within the first 24-48 hours after birth is a vital tool but this can miss some.
• Echocardiography: is the best test. However ECG and CXR have their initial roles. Echo shows structure and function, enabling accurate diagnosis and guiding treatment decisions. Cardiac MRI or CT may be required for more detailed anatomical assessment.
• Management:: Medical management might involve the use of prostaglandins to maintain ductus arteriosus patency or medications to manage heart failure and control symptoms until definitive surgical treatment can be performed.
• Surgical and Interventional Treatment: help correct the structural defects. These surgeries are often complex and need to be performed in specialized centers. Examples include the arterial switch operation for TGA and the Blalock-Taussig shunt for TOF.
• Post-Surgical Complications: Children with CCHD are at risk of various post-surgical complications, including arrhythmias, residual defects, and long-term issues such as heart failure or pulmonary hypertension, polycythaemia.
• Long-Term Management: requires lifelong follow-up with a cardiologist, as they are at risk of late complications, including arrhythmias, ventricular dysfunction, and endocarditis.
• Psychosocial Impact: Chronic illness, frequent hospitalizations, and surgical interventions can have a significant psychosocial impact on the child and family, necessitating support services, including counseling and educational support.
• Growth and Development: Children with CCHD may experience delays in growth and development due to chronic hypoxemia and the stress of recurrent medical interventions. Nutritional support and developmental assessments are essential components of their care.

Table of common defects and management