cyanotic newborn

Question 1

non cardiac vs cardiac cyanosis

Answer 1

non cardiac: central hypoventilation (birth asphyxia, sedation, seizures), respiratory (transient tachypnea of the newborn, respiratory distress syndrome, pneumonia, pneumothorax), persistent pulmonary HTN, anemia, artifact

Cardiac: tetrology of fallot, truncus arteriosus, transposition of the great arteries, Tricuspid atresia, total anomalous pulmonary venous return

Question 2

cyanotic congenital heart disease

Answer 2

the 5Ts
Tetrology of fallot (most common cyanotic CHD)
Truncus arteriosus
Transposition of the great arteries
Tricuspid atresia
Total anomalous pulmonary venous return

Question 3

Tetrology of fallot

Answer 3

Ventricular septal defect, overriding aorta, right ventricular outflow tract obstruction (pulmonary valve or sub pulmonic stenosis), Right ventricular hypertrophy

Most common cyanotic CHD diagnosis (1 in 3500 births)

Genetic associations: digeorge syndrome (22q11 deletion most common underlying genetic association for tetralogy of fallot

Trisomy 21

Question 4

symptoms of Tetrology of fallot

Answer 4

Depends on severity of right ventricular outflow tract obstruction

Have or develop a systolic murmur (systolic ejection murmur at left upper sternal border)
Most children are asymptomatic at birth but symptoms can vary and change, normal saturations to cyanotic (cyanosis develops with increasing RVOTO, Tet spells, hypercyanotic spells dut to infundibular spasm)

Boot shaped upturned apex, reduced pulmonary vasculature, ECG (sinus rhythm, after surgery RBBB,