Important Newborn Cardiac Diagnostic Dilemmas for the Neonatologist and Cardiologist–A Clinical Perspective

Most congenital heart disease (CHD) is readily recognisable in the newborn. Forewarned by previous fetal scanning, presence of a murmur, tachypnoea, cyanosis and/or differential pulses and saturations all point to cardiac abnormality. Yet serious may be missed on scan. There no murmur or clinical cyanosis, tachypneoa attributed non-cardiac causes. Tachypnoea day 1 usually except arising from ventricular failure large systemic arteriovenous fistula. A patent ductus arteriosus (PDA) support either pulmonary duct dependent circulations. The initially high vascular resistance (PVR) limits shunts so that murmurs even communications between circulations take days/weeks develop. At times despite expert input, CHD maybe difficult diagnose warrants close interaction neonatologist cardiologist reach timely diagnosis. Such conditions include obstructed total anomalous venous connections (TAPVC) need distinguish it persistent hypertension newborn (PPHN)–the treatment former surgical latter medical. shunting right left overshadow suspected hypoplastic aortic isthmus coarctation. Is because severe obstruction resulting PVR with little obstruction. diagnosis vein stenosis (PVS) remains problematic often developing premature infants ongoing bronchopulmonary dysplasia (BPD), still being cared for neonatologist. While there are other diagnostic dilemmas including deciding contribution recognised sick neonate, this paper will focus above-mentioned suggestions what done arrive at achieve optimal outcomes.