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

作     者：Samuel Menahem Arvind Sehgal 

作者机构：Department of PaediatricsUniversity of MelbourneMelbourneAustralia School of Clinical SciencesMonash UniversityMelbourneAustralia Monash NewbornCardiovascular ResearchMonash Children’s HospitalMelbourneAustralia Department of PaediatricsMonash UniversityMelbourneAustralia 

出 版 物：《Congenital Heart Disease》 (先天性心脏病（英文）)

年 卷 期：2021年第16卷第2期

页      面：189-196页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 0703[理学-化学] 0702[理学-物理学] 1009[医学-特种医学] 10[医学] 

主　　题：Obstructed pulmonary veins persistent pulmonary hypertension aortic coarctation pulmonary vein stenosis newborn 

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