Cyanotic CHD
Prostaglandin is a dilator of the ductus arteriosus and may delay closure, therefore it should be given as early as possible - Kat Kaminski MD
HWN Suggests
Be Mindful of the Five Terrible T’s
As the ductus arteriosus closes naturally in the first few days of life, neonates with ductal-dependent congenital heart disease can develop circulatory shock. Transposition of the great vessels (TGV) is an example of a ductal-dependent congenital heart disease that also features cyanosis. Ductal-dependent congenital heart diseases that do not typically feature cyanosis include coarctation of the aorta, hypoplastic left heart syndrome, and aortic stenosis.
Treatment of circulatory shock due to suspected ductal-dependent congenital heart disease requires administration of prostaglandin E. Prostaglandin E preserves patency of the ductus arteriosus and can sustain peripheral perfusion…
Articles of Interest
Board Review: It's all about the little people!
Your differential for cyanotic heart disease includes the “5 Terrible Ts”: tetralogy of Fallot, transposition of the great vessels, total anomalous pulmonary venous return, tricuspid atresia, and truncus arteriosus. Further testing should include a hyperoxia test (where a PaO2 < 100mmHg suggests cyanotic cardiac heart disease after several minutes of 100% O2 administration), CXR, EKG, and echo.
Cardiac Emergencies in the First Year of Life
A cyanotic patient suggests that there is cyanotic congenital heart disease with shunting from the right to the left.
Cyanotic congenital heart disease with decreased pulmonary blood flow in children
Of the "five T's" of cyanotic congenital heart disease--tetralogy of Fallot, TGA, TAPVC, truncus, and tricuspid valve abnormalities (tricuspid atresia, stenosis, and displacement)--the first and last are commonly associated with diminished PBF.
