Category Archives: Cardiac

Tip 196: cyanotic congenital heart disease 2

The cyanotic causes of congenital cardiac disease in the neonatal period can be split into: Those with right to left shunt: Pulmonary atresia Tricuspid atresia Ebstein’s anomaly Those with common mixing: Truncus arteriosus, double inlet / outlet ventricles Transpositon of the Great Arteries (TGA) Total … Continue reading

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Tip 194: cyanotic congenital heart disease

Clinical features suggesting a cardiac cause of cyanosis include: Family history of congenital heart disease Antenatal diagnosis / concerns of cardiac anomaly Clear cardiac signs Little / absence of respiratory distress Presence of shock / metabolic acidosis Cyanosis not improving … Continue reading

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Tip 193: PDA 3

The clinical features of a patent ductus arteriosus include: Bounding pulses Active precordium (presence of ventricular heave) Continuous / systolic murmur in pulmonary area (left infraclavicular) Respiratory distress failing to improve or deteriorating at 5 – 10 days of life, including apnoea … Continue reading

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Tip 159: pulse oximetry screening

PulseOx is a large multicentre UK study of pulse oximetry screening (~20,000 neonates >35/40). 53 had major congenital heart disease (24 critical), a prevalence of 2·6/1000 live births. 35 were suspected from antenatal ultrasound scan. After excluding these, the sensitivity of pulse … Continue reading

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Tip 147: hydrocortisone for hypotension

Hydrocortisone is effective in increasing blood pressure, with few other acute side-effects in the sick preterm infant. However, benefit data and long-term safety data are unknown. It is likely that it works by improving the immature neonatal stress response (due to … Continue reading

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Tip 142: dobutamine

Dobutamine is a cardio-selective synthetic analogue of isoprenaline. It possesses both inotropic (beta-1 adrenergic stimulation) and chronotropic (beta-2 adrenergic stimulation) properties. It increases cardiac output by increasing myocardial contractility and stroke volume and causes peripheral vasodilatation. Thus, it is a … Continue reading

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Tip 141: dopamine

Dopamine is a naturally occurring catecholamine precursor of noradrenaline. Dopamine affects all three major determinants of cardiovascular function (preload, myocardial contractility and afterload). It increases myocardial contractility, heart rate and systemic vascular resistance by stimulation of the alpha and beta receptors. … Continue reading

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