Aberrant embryonic development results in mixing of deoxygenated and oxygenated blood returning to systemic circulation by 2 mechanisms:
Right-to-left intracardiac shunt
Most common initial ED presentations of cyanotic congenital heart disease (CHD):
Physiologic stress triggers cyanosis in older patients with CHD:
Cardiac shunt o...
Maintain warmth (cold ↑ O2 consumption).
Treat hypoglycemia and acidosis.
Establish IV access.
Prepare for endotracheal intubation.
High oxygen ...
All newborns with suspected CHD:
Admit to pediatric ICU.
CHD with acute worsening of cyanosis or CHF
CHD with symptomatic pneumonia or respiratory syncytial virus
Visual appearance of cyanosis requires >3–5 mg/dL deoxygenated hemoglobin.
Present at 2–3 wk of age
Sudden cyanosis or cardiovascular collapse
Treat with PGE...
Apitz C, Webb GD, Redington AN. Tetralogy of Fallot. Lancet. 2009;374:1462–1471.
Bonow RO, Mann DL, Zipes DP, et al., eds. Congenital heart disease. Braunwald's Heart Dis...
745.2 Tetralogy of fallot
745.4 Ventricular septal defect
746.89 Other specified congenital anomalies of heart
747.21 Anomalies of aortic arch
745.10 Complete transposition of ...
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