1. Because sepsis is strongly suspected in any neonate presenting to the emergency department in distress, a complete diagnostic evaluation for infection should be performed, and antibiotic therapy should be initiated concomitant with the evaluation for CHD.
2. Despite recent advances in antenatal ultrasound, the majority of patients with CHD are diagnosed after delivery.
3. Functional closure of the DA may be delayed in children with CHD. As a result, patients with ductal-dependent lesions will become symptomatic after discharge from the neonatal nursery.
4. The timing of presentation of CHD is bimodal. Patients with ductal-dependent defects will present in the first month of life, while patients with predominantly left-to-right shunting lesions will present between 2-6 months of age.
5. A ductal-dependent CHD should be considered in any neonate less than 1 month of age who presents with sudden cardiovascular collapse. These lesions have the highest incidence of mortality prior to surgical correction.
Posted by empracticenews 