Category Archives: Cardiac

Tip 82: supraventricular tachycardia (SVT)

Presentation varies from antenatal hydrops and tachycardia, neonatal heart failure within the first 12-24 hours, to being asymptomatic. The termination of SVT is usually easily achieved by vagal manoeuvres or intravenous adenosine. Unusually DC shock is needed, especially with evidence … Continue reading

Posted in Cardiac | Leave a comment

Tip 78: PDA medical treatment

Treatment of a symptomatic PDA in a preterm infant is usually by fluid restriction (and waiting for spontaneous closure) or ibuprofen (indomethacin is no longer available in the UK.) The Cochrane review below included the following findings. IV ibuprofen showed a … Continue reading

Posted in Cardiac, Prematurity | Leave a comment

Tip 76: PDA 2

Due to an increased left (aorta) to right (pulmonary artery) shunting, a significant PDA is associated with renal impairment / failure, intestinal perforation / NEC, and severe IVH / PVL, possibly due to systemic ‘steal’. The increase pulmonary blood flow can … Continue reading

Posted in Cardiac, Prematurity | Leave a comment

Tip 75: patent ductus arteriosus (PDA)

The incidence of PDA in term infants is ~6: 10,000 live births. In preterm infants, especially <1500g, the incidence can be up to 33%. Over half of infants weighing <1kg are symptomatic and require medical treatment for PDA closure. Reference: … Continue reading

Posted in Cardiac, Prematurity | Leave a comment

Tip 41: congenital heart disease

The prevalence of structural congenital heart disease is approximately 5 per 1,000 total births (~0.5%). The antenatal diagnosis of serious congenital heart disease is only 50%. The incidence of heart murmurs on day 1 examination, however, may be as high as … Continue reading

Posted in Antenatal, Cardiac, Congenital anomalies | Leave a comment

Tip 39: persistent pulmonary hypertension of the newborn (PPHN)

The main principles for managing persistent pulmonary hypertension of the newborn (PPHN) are: Treat & prevent hypoxia – aim pO2 ≥10 kPa and/or sats ≥95% (preductal) Treat acidosis – aim pH ≥7.35 Treat & prevent hypotension – aim BP > … Continue reading

Posted in Cardiac, Respiratory | Leave a comment

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

Posted in Cardiac | Leave a comment