The Critically Ill Infant with Congenital Heart Disease - 29/07/15

Doi : 10.1016/j.emc.2015.04.002

Ashley M. Strobel, MD ^a,^b, Le N. Lu, MD ^c,^⁎
^a Department of Emergency Medicine, University of Maryland Medical Center, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA
^b Department of Pediatrics, University of Maryland Medical Center, 22 South Greene Street, North Hospital, 5th floor, Baltimore, MD 21201, USA
^c Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA

^∗Corresponding author.

Résumé

This article presents an approach for identification of infants with congenital heart disorders. These disorders are difficult to diagnose because of the complexity and variety of cardiac malformations; additionally presentation can be complicated by age-dependent physiology. By compiling data from the history and the physical examination, the emergency physician can identify lesion category and initiate stabilization procedures. Critical congenital cardiac lesions can be classified as left-sided obstructive ductal dependent, right-sided obstructive ductal dependent, and shunting or mixing. The simplified approach categorizes infants with these lesions respectively as “pink,” “blue,” or “gray.” The emergency provider can provide life-saving stabilization until specialized care can be obtained.

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Keywords : Congenital heart disease, Cyanotic cardiac disease, Pediatric cardiology, Critically ill neonate, Decompensated neonate