Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination!
| Title: | Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination! |
|---|---|
| Authors: | Deepika Sankaran, Heather Siefkes, Frank F. Ing, Satyan Lakshminrusimha, Francis R. Poulain |
| Source: | American Journal of Perinatology Reports, Vol 11, Iss 02, Pp e84-e90 (2021) |
| Publisher Information: | Thieme Medical Publishers, Inc., 2021. |
| Publication Year: | 2021 |
| Collection: | LCC:Gynecology and obstetrics |
| Subject Terms: | newborn, congenital heart disease, pulse oximetry, cchd screening, pulmonary atresia, pa-vsd, oximetry screening, false negative, pulse oximetry screening, critical congenital heart disease, Gynecology and obstetrics, RG1-991 |
| More Details: | Pulse oximetry oxygen saturation (SpO2)-based critical congenital heart disease (CCHD) screening is effective in detection of cyanotic heart lesions. We report a full-term male infant with normal perfusion who had passed the CCHD screening at approximately 24 hours after birth with preductal SpO2 of 99% and postductal SpO2 of 97%. Detection of a loud systolic cardiac murmur before discharge led to the diagnosis of pulmonary atresia (PA) with ventricular septal defect (PA-VSD) by echocardiogram. The infant was transferred to a tertiary care center after initiation of prostaglandin E1 (PGE1) therapy. Throughout the initial course, he was breathing comfortably without respiratory distress or desaturations on pulse oximetry. We believe that this is the first documented report of PA missed by CCHD screening. Thorough and serial clinical examinations of the newborn infant proved vital in the timely diagnosis of this critical disease. We review the hemodynamics and the recent literature evaluating utility of CCHD screening in the diagnosis of PA-VSD. Pulse oximetry–based CCHD screening should be considered a tool to enhance CCHD detection with an emphasis on detailed serial physical examinations in newborn infants. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2157-6998 2157-7005 |
| Relation: | https://doaj.org/toc/2157-6998; https://doaj.org/toc/2157-7005 |
| DOI: | 10.1055/s-0041-1727275 |
| Access URL: | https://doaj.org/article/5de33dff458c4f169c91c5608a21ffc8 |
| Accession Number: | edsdoj.5de33dff458c4f169c91c5608a21ffc8 |
| Database: | Directory of Open Access Journals |
| ISSN: | 21576998 21577005 |
|---|---|
| DOI: | 10.1055/s-0041-1727275 |
| Published in: | American Journal of Perinatology Reports |
| Language: | English |