Congenital Heart Disease

Abstract

Congenital heart disease (CHD) is common, affecting approximately 8 in 1000 live-born children, and encompasses a broad range of diagnoses and presentations. CHDs can include inborn derangements in almost any aspect of the hearts structure of function, but the most common type of congenital heart disease are structural lesions of the heart that affect the normal pattern of blood flow. These structural lesions can present with varied symptoms and physical exam signs that are rooted in their underlying blood flow patterns often lead to one of four groups of diseases based on blood flow patterns. Overcirculation, systemic outflow obstruction, systolic failure, and cyanosis are the four groups used as descriptive classifications of structural CHD. CHD findings can be present prenatally, in the newborn nursery, and well child office visits, but very often present to the EDs without any cardiac history when the lesion progresses to a point of crisis when the cardiac output is no longer meeting the body’s perfusion demands. Early presentations of CHD frequently are related to closure of the ductus arteriosus and may benefit from early treatment with prostaglandin E. Lab tests, radiology studies, and exam findings may be suggestive of certain types of lesions, but the gold standard to determine the type of CHD is an echocardiogram. Once the diagnosis of CHD is suspected, consultation with a pediatric cardiologist is highly recommended to arrange the timely evaluation of the child and prompt initiation of therapies if needed to mitigate the disease progression. Key words: Congenital heart disease, overcirculation, systemic outflow obstruction, systolic failure, and cyanosis, ductus arteriosus