Early diagnosis of the newborn with critical congenital heart disease: A practical approach for pediatrician
Rahmat Budi Kuswiyanto
Department of Pediatric and Child Health
Hasan Sadikin HospitalUniversitas Padjadajaran
Congenital heart disease or congenital heart defects (CHD) are the most common structural malformation present at birth, affects nearly 1% of births, or nearly 50,000 infants yearly in Indonesia.Critical congenital heart defects (CCHDs), affects 25% of CHDs, are those requiring surgical or catheter-based intervention in the first year of life and remains one of the most significant causes of infant death.The risk of morbidity and mortality increases when there is a delay in diagnosis and timely referral. Early detection of CCHD by pediatrician could potentially improve the prognosis and decrease the mortality and morbidity rate of affected infants.Many newborns with CCHD are symptomatic and identified soon after birth; others are not diagnosed until after discharge. The cardinal signs and symptoms of CCHD are included cyanosis, tachypnea, poor perfusion andfemoral pulses, murmur, and poor weight gain.If those sign and symptoms are not present, routine pulse oximetry performed properly onasymptomatic newborns after 24 hours of life may detect CCHD. The pediatrician as primary care provider couldcombine both the cardinal sign and symptoms of CCHD identification and pulse oximetry examination at the nursery, first week and 1-month follow-up as the practical evaluation strategy to enhance early detection and diagnosis of CCHD.
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