Summary Listen
- Congenital heart defects (CHDs) are the most common congenital malformations, affecting 1-1.6% of live births, with critical and severe CHDs leading to high mortality in the first year of life due to lack of diagnosis or treatment. Early detection through screening is crucial to improve outcomes.
- Embryogenesis of the cardiovascular system occurs early in pregnancy (15th-58th day), often before awareness of pregnancy. Fetal circulation differs significantly from postnatal circulation, with parallel pulmonary and systemic circuits and a dominant right ventricle. Adaptations after birth, including ductus arteriosus closure and decreased pulmonary resistance, take time.
- Obstetricians play a key role in identifying risk factors for CHDs (maternal history, medications, family history) and utilizing prenatal screening tools like nuchal translucency measurement and fetal echocardiography to detect abnormalities. Fetal interventions are sometimes possible for severe valve stenosis.
- Pulse oximetry screening after birth, in conjunction with clinical examination, helps detect critical CHDs, early-onset sepsis, and respiratory diseases. Measurement should occur after 24 hours of life, comparing pre- and post-ductal saturation levels to identify discrepancies indicative of heart defects.
- Neonatologists are vital in identifying CHDs based on prenatal diagnoses, family history, and clinical presentation (cyanosis, low perfusion, tachypnea). Syndromes associated with CHDs (Trisomy 21, DiGeorge syndrome, etc.) should be considered, and differential diagnoses should include respiratory and metabolic disorders.
- Pediatricians play a critical role in identifying late-onset presentations of critical and severe CHDs during routine physical examinations, particularly at the six-week visit. Failure to thrive or unexplained murmurs should raise suspicion.
- Pediatric cardiologists are essential for confirming diagnoses, excluding non-cardiac conditions, providing medical support, and facilitating referral for interventional or surgical treatment.
- Early suspicion, comprehensive screening, and prompt intervention are key to improving the outcomes for infants with critical and severe CHDs.
Sample Certificate
About the Speakers
Dr. Andreas C Petropoulos
Senior Consultant Pediatric & Adult Congenital Cardiologist, Pediatric Intensivist Ass. Director of Center of CHD, Euroclinic- Athens REA Maternity Hospital, Athens, Greece
Comments
Comments
You must be logged in to leave a comment.