Identification of congenital heart defects

Children with congenital heart disease present with one or three pathophysiological states such as,

1. Low cardiac output - this defect occurs when obstruction of blood flow from the heart and also heart is unstable to pump effectively.
2. Congestive heart failure - this occurs when an increase in blood flow in the lungs
3. Cyanosis - this occurs when a decrease in blood flow in the lungs.

   

   
   

On admission of the patient for the cardiac assessment,

1. SUBJECTIVE EXAMINATION - Has to be taken to identify the Prenatal diagnosis or significant birth and genetic defects. 
2. OBJECTIVE EXAMINATION - A complete baseline study has to be taken in a child for assessing the vital signs of cerebral blood pressure in all four extremities to evaluate any gradient within the aorta.  

PHYSICAL EXAMINATION

The assessment of skin color, body temperature, heart sound, and a heart murmur, and also to check the liver in the right side of the heart for any fluid collection in it and also to check the quality and strength of the pulse.

DIAGNOSTIC TESTING

• Chest radiograph
• Electrocardiogram
• Echocardiogram, and
• Cardiac catheterization. 

SIGNS OF LOW CARDIAC OUTPUT 

In infancy,

• Pale color
• Irritability
• Coldness
• Loss of consciousness
• Capillary refill greater than 3 seconds
• Low urine output. 
• Weak pulse
• Temperature instability
• Apnea and
• Organ damage such as liver and kidney failure.

 Later signs such as hypertension, cyanosis, altered mental status.

TO IMPROVE LOW CARDIAC OUTPUT 

• Administration of fluids 
• Correcting acid-base imbalances
• Electrolyte abnormalities and
• Meditations to improve Heart function and reduce stress on the body.

30 % of the children and infants are mostly affected by congenital heart disease And also 70 % of the children or affected by Complex heart disease.

 

SIGNS OF CONGESTIVE HEART FAILURE 

• Pulmonary edema
• Irritability
• Changes in responsiveness
• Fatigue
• Poor feeding
• Cold skin
• Tachycardia
• Large liver
• Decreased urine output
• Periorbital edema
• Primary effusion and 
• Ascites

TO IMPROVE CONGESTIVE HEART FAILURE  

• Medications such as diuretics to decrease fluid accumulation 
• Limiting fluid administration, Improve nutrition to maximize calories
• Temperature control 
• Respiratory support To reduce the work of breathing. 

DIAGNOSIS OF RESPIRATORY AND CARDIAC DISEASE

• 12 lead Electrocardiogram
• Chest radiograph

Hyperoxia test (which is used to evaluate oxygen content of the blood with and without supplemental oxygen).