Critical Congenital Heart Disease in Neonates: A Review Article

Author(s): Amar Taksande*, Patel Zeeshan Jameel

Journal Name: Current Pediatric Reviews

Volume 17 , Issue 2 , 2021


Become EABM
Become Reviewer
Call for Editor

Abstract:

Critical congenital heart defects (CCHDs) are serious malformations that remain to be an important cause of neonatal mortality and morbidity. The clinical presentations of CCHD are shock, cyanosis, or respiratory distress, which may be similar to that of other neonatal conditions. Failure to diagnose these conditions early on after birth may result in acute cardiovascular collapse and death. Screening with routine pulse oximetry is efficient in distinguishing newborns with CCHD and other hypoxemic illnesses, which may otherwise be potentially life-threatening. If the cardiovascular system cannot be observed by echocardiography, then treatment with continuous prostaglandin-E1(PGE1) infusion should be started in any newborn whose condition deteriorates in the first few days of life. This review aims to provide a concise summary of the presentation and management of various CCHDs and to emphasize the role of timely diagnosis in the management.

Keywords: Critical, congenital, heart disease, neonate, prostaglandin-E1, ductus arteriosus.

[1]
Plana MN, Zamora J, Suresh G, Fernandez-Pineda L, Thangaratinam S, Ewer AK. Pulse oximetry screening for critical congenital heart defects. Cochrane Database Syst Rev 2018.https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011912.pub2/full
[http://dx.doi.org/10.1002/14651858.CD011912.pub2]
[2]
Taksande A, Meshram R, Lohakare A, Purandare S, Biyani U, Vagha J. An update work of pulse oximetry screening for detecting critical congenital heart disease in the newborn. Images Paediatr Cardiol 2017; 19(3): 12-8.
[PMID: 29731786]
[3]
Fillipps DJ, Bucciarelli RL. Cardiac evaluation of the newborn. Pediatr Clin North Am 2015; 62(2): 471-89.
[http://dx.doi.org/10.1016/j.pcl.2014.11.009] [PMID: 25836709]
[4]
Khalil M, Jux C, Rueblinger L, Behrje J, Esmaeili A, Schranz D. Acute therapy of newborns with critical congenital heart disease. Transl Pediatr 2019; 8(2): 114-26.
[http://dx.doi.org/10.21037/tp.2019.04.06] [PMID: 31161078]
[5]
Riede FT, Wörner C, Dähnert I, Möckel A, Kostelka M, Schneider P. Effectiveness of neonatal pulse oximetry screening for detection of critical congenital heart disease in daily clinical routine--results from a prospective multicenter study. Eur J Pediatr 2010; 169(8): 975-81.
[http://dx.doi.org/10.1007/s00431-010-1160-4] [PMID: 20195633]
[6]
Teitel D. Recognition of Undiagnosed Neonatal Heart Disease. Clin Perinatol 2016; 43(1): 81-98.
[http://dx.doi.org/10.1016/j.clp.2015.11.006] [PMID: 26876123]
[7]
Eckersley L, Sadler L, Parry E, Finucane K, Gentles TL. Timing of diagnosis affects mortality in critical congenital heart disease. Arch Dis Child 2016; 101(6): 516-20.
[http://dx.doi.org/10.1136/archdischild-2014-307691] [PMID: 26130379]
[8]
Brown KL, Ridout DA, Hoskote A, Verhulst L, Ricci M, Bull C. Delayed diagnosis of congenital heart disease worsens preoperative condition and outcome of surgery in neonates. Heart 2006; 92(9): 1298-302.
[http://dx.doi.org/10.1136/hrt.2005.078097] [PMID: 16449514]
[9]
Mahle WT, Newburger JW, Matherne GP, et al. American Heart Association Congenital Heart Defects Committee of the Council on Cardiovascular Disease in the Young, Council on Cardiovascular Nursing, and Interdisciplinary Council on Quality of Care and Outcomes Research; American Academy of Pediatrics Section on Cardiology and Cardiac Surgery, and Committee on Fetus and Newborn. Role of pulse oximetry in examining newborns for congenital heart disease: a scientific statement from the American Heart Association and American Academy of Pediatrics. Circulation 2009; 120(5): 447-58.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192576] [PMID: 19581492]
[10]
Lee JY. Clinical presentations of critical cardiac defects in the newborn: Decision making and initial management. Korean J Pediatr 2010; 53(6): 669-79.
[http://dx.doi.org/10.3345/kjp.2010.53.6.669] [PMID: 21189937]
[11]
Krishna MR, Kumar RK. Diagnosis and management of critical congenital heart diseases in the newborn. Indian J Pediatr 2020; 87(5): 365-71.
[http://dx.doi.org/10.1007/s12098-019-03163-4] [PMID: 31989462]
[12]
Massin MM, Dessy H. Delayed recognition of congenital heart disease. Postgrad Med J 2006; 82(969): 468-70.
[http://dx.doi.org/10.1136/pgmj.2005.044495] [PMID: 16822925]
[13]
Chang R-KR, Gurvitz M, Rodriguez S. Missed diagnosis of critical congenital heart disease. Arch Pediatr Adolesc Med 2008; 162(10): 969-74.
[http://dx.doi.org/10.1001/archpedi.162.10.969] [PMID: 18838650]
[14]
Glidewell J, Olney RS, Hinton C, et al. Centers for Disease Control and Prevention (CDC). State Legislation, Regulations, and Hospital Guidelines for Newborn Screening for Critical Congenital Heart Defects - United States, 2011-2014. MMWR Morb Mortal Wkly Rep 2015; 64(23): 625-30.
[PMID: 26086632]
[15]
Liberman RF, Getz KD, Lin AE, et al. Delayed diagnosis of critical congenital heart defects: trends and associated factors. Pediatrics 2014; 134(2): e373-81.
[http://dx.doi.org/10.1542/peds.2013-3949] [PMID: 25070301]
[16]
Strobel AM, Lu N. The Critically Ill Infant with Congenital Heart Disease. Emerg Med Clin North Am 2015; 33(3): 501-18.
[http://dx.doi.org/10.1016/j.emc.2015.04.002] [PMID: 26226862]
[17]
van der Linde D, Konings EEM, Slager MA, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 2011; 58(21): 2241-7.
[http://dx.doi.org/10.1016/j.jacc.2011.08.025] [PMID: 22078432]
[18]
CDC. Congenital Heart Defects Information for Healthcare Providers | CDC. Centers for Disease Control and Prevention 2019.https://www.cdc.gov/ncbddd/heartdefects/hcp.html
[19]
Martin GR, Ewer AK, Gaviglio A, Hom LA, Saarinen A, Sontag M, et al. Updated strategies for pulse oximetry screening for critical congenital heart disease. Pediatrics 2020; 146(1)https://pediatrics.aappublications.org/content/146/1/e20191650
[20]
Kwiatkowski DM, Hanley FL, Krawczeski CD. Right Ventricular Outflow Tract Obstruction: Pulmonary Atresia With Intact Ventricular Septum, Pulmonary Stenosis, and Ebstein’s Malformation. Pediatr Crit Care Med 2016; 17(8)(Suppl. 1): S323-9.
[http://dx.doi.org/10.1097/PCC.0000000000000818] [PMID: 27490618]
[21]
Townsley MM, Windsor J, Briston D, Alegria J, Ramakrishna H. Tetralogy of Fallot: Perioperative Management and Analysis of Outcomes. J Cardiothorac Vasc Anesth 2019; 33(2): 556-65.
[http://dx.doi.org/10.1053/j.jvca.2018.03.035] [PMID: 29706570]
[22]
Wernovsky G. Transposition of the Great Arteries and Common Variants. Pediatr Crit Care Med 2016; 17(8)(Suppl. 1): S337-43.
[http://dx.doi.org/10.1097/PCC.0000000000000819] [PMID: 27490620]
[23]
Sarris GE, Balmer C, Bonou P, et al. Clinical guidelines for the management of patients with transposition of the great arteries with intact ventricular septum. Eur J Cardiothorac Surg 2017; 51(1): e1-e32.
[http://dx.doi.org/10.1093/ejcts/ezw360] [PMID: 28077506]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 17
ISSUE: 2
Year: 2021
Published on: 19 February, 2021
Page: [120 - 126]
Pages: 7
DOI: 10.2174/1573396317666210219162515
Price: $65

Article Metrics

PDF: 514
HTML: 1