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American Academy of Pediatrics
Article

Congenital Heart Disease

Kriti Puri, Hugh D. Allen and Athar M. Qureshi
Pediatrics in Review October 2017, 38 (10) 471-486; DOI: https://doi.org/10.1542/pir.2017-0032
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Kriti Puri
*Department of Pediatrics,
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Hugh D. Allen
*Department of Pediatrics,
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Athar M. Qureshi
*Department of Pediatrics,
†CE Mullins Cardiac Catheterization Laboratories, The Lillie Frank Abercombie Section of Cardiology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
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  1. Kriti Puri, MD*
  2. Hugh D. Allen, MD*
  3. Athar M. Qureshi, MD*,†
  1. *Department of Pediatrics,
  2. †CE Mullins Cardiac Catheterization Laboratories, The Lillie Frank Abercombie Section of Cardiology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
  • AUTHOR DISCLOSURE

    Drs Puri, Allen, and Qureshi have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

  • Abbreviations:
    ASD:
    atrial septal defect
    AVSD:
    atrioventricular septal defect
    CHD:
    congenital heart disease
    CHF:
    congestive heart failure
    CoA:
    coarctation of the aorta
    EKG:
    electrocardiogram
    HLHS:
    hypoplastic left heart syndrome
    IAA:
    interrupted aortic arch
    IVC:
    inferior vena cava
    LV:
    left ventricle
    mBTT:
    modified Blalock-Taussig-Thomas
    PAPVD:
    partial anomalous pulmonary venous drainage
    PDA:
    patent ductus arteriosus
    RV:
    right ventricle
    SBE:
    subacute bacterial endocarditis
    TAPVD:
    total anomalous pulmonary venous drainage
    VSD:
    ventricular septal defect
  • Education and Practice Gaps

    Congenital heart disease (CHD) is present in about 9 of every 1,000 live-born children. (1)(2)(3)(4)(5) Children with CHD are surviving longer, and better understanding of the long-term complications of CHD is continuously emerging. Hence, it is important to be comfortable with the primary care requirements for these children, including physical manifestations prior to surgery and interventional cardiac catheterizations, as well as those concerning for potential need for reintervention, the latest recommendations for endocarditis prophylaxis, respiratory precautions and immunization considerations, and close monitoring of development and behavior. In this article, we will discuss the common types of cyanotic (“blue”) and acyanotic (“pink”) CHD and the role of the primary care physician in the health care of these children before and after surgery and interventional cardiac catheterizations.

    Objectives

    After completing this article, readers should be able to:

    1. Describe newborn pulse oximetry screening for congenital heart disease (CHD) and clinical features of CHD during the newborn period.

    2. Describe the clinical presentations and briefly outline management strategies of infants and children with different types of CHD.

    3. Discuss single-ventricle palliation by using hypoplastic left heart syndrome as the model lesion.

    4. Describe the evaluation and primary care management factors (including endocarditis prophylaxis, immunizations, and exercise restriction) in children with different types of CHD.

    Newborn Presentation of Critical Congenital Heart Disease

    Newborns with critical congenital heart disease (CHD) may present with symptoms of cyanosis, congestive heart failure (CHF), poor pedal pulses, or a failed newborn CHD pulse oximetry screen prior to discharge. CHD lesions that are dependent on a patent ductus arteriosus (PDA) to support flow either to the systemic circulation or to the pulmonary circulation …

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    In this issue

    Pediatrics in Review: 38 (10)
    Pediatrics in Review
    Vol. 38, Issue 10
    1 Oct 2017
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    Congenital Heart Disease
    Kriti Puri, Hugh D. Allen, Athar M. Qureshi
    Pediatrics in Review Oct 2017, 38 (10) 471-486; DOI: 10.1542/pir.2017-0032

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    Congenital Heart Disease
    Kriti Puri, Hugh D. Allen, Athar M. Qureshi
    Pediatrics in Review Oct 2017, 38 (10) 471-486; DOI: 10.1542/pir.2017-0032
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    • Article
      • Education and Practice Gaps
      • Objectives
      • Newborn Presentation of Critical Congenital Heart Disease
      • Acyanotic Heart Disease
      • Cyanotic CHD
      • General Principles of Immunization, Subacute Bacterial Endocarditis Prophylaxis, and Postoperative and Cardiac Catheterization Care
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