Congenital heart disease systemic diseases (such as acute rheumatic carditis and viral myocarditis) Cardiomyopathy Tachyarrhythmi post cardiac surgery

Congenital heart disease are heart problems that develop before birth. They can occur in the heart's chambers, valves or blood vessels. A baby may be born with only one defect or with several defects. Of the dozens of heart defects, some are mild and may need little or no medical treatment even through adulthood. Other types of congenital heart defects are life-threatening, either immediately to the newborn or over time

Commonly

presents with Central cyanosis Heart failure Sudden collapse Heart murmur

Bluish discoloration of lips and mucous membrane Confirmed by pulse oxymetry(spo25Gm/dL)

Cyanotic heart diseases- obstructed pulmonary flow(TOF,pulmonary atresia - common mixing(single ventricle,truncus arteriosus, tricuspid atresia, total anomalous pulmonary venous drainage(TAPVD)) Primary pulmonary diseases Persistent pulmonary hypertension of newborn(PPHN) Central nervous depression Severe polycythaemia methaemoglobinaemia

Clinical presentation may mimic pulmonary diseases or sepsis. Tachypnoea Tachycardia Hepatomegaly Weak pulses

Can be difficult to be distinguished from sepsis or metabolic disorders. Hypotension Metabolic acidosis Extreme cyanosis oliguria

Identification of a heart murmur during routine newborn examination is common Absence of heart murmur does not exclude serious structural heart problems(e.g TGA,TAPVD,AVSD) Heart murmur can be innocent or pathological

Pulmonary flow murmur Transient systolic murmur from closing ductus arteriosus Transient systolic murmur from tricuspid regurgitation due to high pulmonary vascular resistance

History Antenatal scan(cardiac malformation,fetal arrhytmias,hydrops) Family history of congenital heart disease Maternal illness:diabetis,rubella,teratogenic medications Perinatal problems:prematurity,meconium aspiration,perinatal asphyxia

Physical examination Dysmorphism Central cyanosis Differential cyanosis(spo2 lower limb