Question

Congenital heart disease means that the infant was born with a heart defect. The sound of this can be devasting until it is understood

1. what exactly the defect is?
2. What stage of development is the heart developed in the fetus?
3. There are two types of heart defects cyanotic and acyanotic. Explain what each means by describing blood flow?
4. How is it flowing and why it is cyanotic or not?
5. How do these defects complicate neonatal assessment and oxygen delivery?

Answer 1

• Congenital heart defect is the inability of the heart to pump a sufficient amount of blood to meet the metabolical and oxygen needs of the body.In infant and children,inadequate cardiac output most commonly is caused by congenital heart defects(shunt,obstruction,or a combination of both) that produce an excessive volume or pressure load on the myocardium.
• In human embryos the heart begins to beat at about 22-23 days, with blood flow beginning in the 4th week. The heart is therefore one of the earliest differentiating and functioning organs. The heart begins very early in mesoderm within the trilaminar embryonic disc.found that the heart has four clearly defined chambers in the eighth week of pregnancy, but does not have fully organized muscle tissue until the 20th week.
• Acyanotic heart defects is an abnormal connection between the great arteries that allows blood to flow from the high pressure left side of the heart to the low pressure right side of the heart.The common cyanotic heart defects are atrial septal defect(abnormal opening between the atria),atrioventricular canal defect(incomplete fusion of the endocardial cushions),patent ductus arteriosus and ventricular septal defect. Cyanotic heart disease refers to a group of many different heart defects that are present at birth (congenital). They result in a low blood oxygen level. Cyanosis refers to a bluish color of the skin and mucous membranes.Aortic stenosis,coarctation of the aorta,tetrology of Fallot,Tetralogy of Fallot,Total anomalous pulmonary venous return,Transposition of the great arteries are the example for cyanotic heart defect.

• Heart defects that children are born with can change the way blood flows through the heart and lungs. These defects can cause less blood to flow to the lungs. They can also result in blue and red blood mixing together. This causes poorly oxygenated blood to be pumped out to the body. As a result the blood that is pumped out to the body is lower in oxygen and less oxygen delivered to the body can make the skin look blue (cyanosis). Some of these heart defects involve the heart valves. These defects force blue blood to mix with red blood through abnormal heart channels. Heart valves are found between the heart and the large blood vessels that bring blood to and from the heart. These valves open up enough for blood to flow through. Then they close, keeping blood from flowing backward.

• These congenital defects causes complication in neonatal assessment. They are decreased peripheral pulses,exercise Intolerance, hypotension,lethargy,restlessness,oliguria,pale and cool Extremities ,difficulty in feeding and tachycardia. These complications should monitored quickly and take action for that. Medical and surgical intervention is needed once it is noted.