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Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination!

Pulse oximetry oxygen saturation (SpO (2) )-based critical congenital heart disease (CCHD) screening is effective in detection of cyanotic heart lesions. We report a full-term male infant with normal perfusion who had passed the CCHD screening at approximately 24 hours after birth with preductal SpO...

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Autores principales: Sankaran, Deepika, Siefkes, Heather, Ing, Frank F., Lakshminrusimha, Satyan, Poulain, Francis R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers, Inc. 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208842/
https://www.ncbi.nlm.nih.gov/pubmed/34150354
http://dx.doi.org/10.1055/s-0041-1727275
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author Sankaran, Deepika
Siefkes, Heather
Ing, Frank F.
Lakshminrusimha, Satyan
Poulain, Francis R.
author_facet Sankaran, Deepika
Siefkes, Heather
Ing, Frank F.
Lakshminrusimha, Satyan
Poulain, Francis R.
author_sort Sankaran, Deepika
collection PubMed
description Pulse oximetry oxygen saturation (SpO (2) )-based critical congenital heart disease (CCHD) screening is effective in detection of cyanotic heart lesions. We report a full-term male infant with normal perfusion who had passed the CCHD screening at approximately 24 hours after birth with preductal SpO (2) of 99% and postductal SpO (2) of 97%. Detection of a loud systolic cardiac murmur before discharge led to the diagnosis of pulmonary atresia (PA) with ventricular septal defect (PA-VSD) by echocardiogram. The infant was transferred to a tertiary care center after initiation of prostaglandin E1 (PGE1) therapy. Throughout the initial course, he was breathing comfortably without respiratory distress or desaturations on pulse oximetry. We believe that this is the first documented report of PA missed by CCHD screening. Thorough and serial clinical examinations of the newborn infant proved vital in the timely diagnosis of this critical disease. We review the hemodynamics and the recent literature evaluating utility of CCHD screening in the diagnosis of PA-VSD. Pulse oximetry–based CCHD screening should be considered a tool to enhance CCHD detection with an emphasis on detailed serial physical examinations in newborn infants.
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spelling pubmed-82088422021-06-17 Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination! Sankaran, Deepika Siefkes, Heather Ing, Frank F. Lakshminrusimha, Satyan Poulain, Francis R. AJP Rep Pulse oximetry oxygen saturation (SpO (2) )-based critical congenital heart disease (CCHD) screening is effective in detection of cyanotic heart lesions. We report a full-term male infant with normal perfusion who had passed the CCHD screening at approximately 24 hours after birth with preductal SpO (2) of 99% and postductal SpO (2) of 97%. Detection of a loud systolic cardiac murmur before discharge led to the diagnosis of pulmonary atresia (PA) with ventricular septal defect (PA-VSD) by echocardiogram. The infant was transferred to a tertiary care center after initiation of prostaglandin E1 (PGE1) therapy. Throughout the initial course, he was breathing comfortably without respiratory distress or desaturations on pulse oximetry. We believe that this is the first documented report of PA missed by CCHD screening. Thorough and serial clinical examinations of the newborn infant proved vital in the timely diagnosis of this critical disease. We review the hemodynamics and the recent literature evaluating utility of CCHD screening in the diagnosis of PA-VSD. Pulse oximetry–based CCHD screening should be considered a tool to enhance CCHD detection with an emphasis on detailed serial physical examinations in newborn infants. Thieme Medical Publishers, Inc. 2021-04 2021-06-16 /pmc/articles/PMC8208842/ /pubmed/34150354 http://dx.doi.org/10.1055/s-0041-1727275 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Sankaran, Deepika
Siefkes, Heather
Ing, Frank F.
Lakshminrusimha, Satyan
Poulain, Francis R.
Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination!
title Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination!
title_full Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination!
title_fullStr Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination!
title_full_unstemmed Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination!
title_short Critical Congenital Heart Disease Detection in the Screening Era: Do Not Neglect the Examination!
title_sort critical congenital heart disease detection in the screening era: do not neglect the examination!
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208842/
https://www.ncbi.nlm.nih.gov/pubmed/34150354
http://dx.doi.org/10.1055/s-0041-1727275
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