Chapter 17 - Complications of congenital heart disease

Abstract

This chapter reviews complications of congenital heart disease. Thrombosis is a common complication of cyanotic congenital heart disease and is most serious when it occurs in the cerebral circulation. Its onset is often insidious and in young children the presence of malaise and headache may be overlooked. Cerebral abscess is rare in children under 2 years of age; infection probably occurs in an area where there has been some previous local damage following thrombosis. When a child with congenital heart disease has bacterial organisms in the blood stream, there is always a chance that infective endocarditis will result. The disease can occur at any age, but is uncommon below the age of 2 years. The source of infection is probably the mouth in about one-eighth of cases, but nose, throat, and tonsils are other common sites of entry. The acid–base status of the blood and extracellular fluid are closely linked. There are three variables—the carbon dioxide tension, pH, and buffer concentrations. Any blood pH imbalance abnormality might lead to severe consequences. Abnormalities of acid–base balance in blood are metabolic acidosis, metabolic alkalosis, respiratory acidosis, respiratory alkalosis, and cardiac arrest.