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Cyanotic heart disease


Definition:

Cyanotic heart disease is a heart defect, present at birth (congenital), that results in low blood oxygen levels. There may be more than one defect.

Alternative Names:

Right-to-left cardiac shunt; Right-to-left circulatory shunt

Signs and tests:

Physical examination confirms cyanosis. The child may have clubbed fingers.

The doctor will listen to the heart and lungs with a stethoscope. Abnormal heart sounds, a heart murmur, and lung crackles may be heard.

Tests will vary depending on the cause, but may include:

Treatment:

Some infants may need to stay in the hospital after birth so they can receive oxygen or be put on a breathing machine. They may receive medicines to:

  • Get rid of extra fluids
  • Help the heart pump harder
  • Keep certain blood vessels open
  • Treat abnormal heartbeats or rhythms

The treatment of choice for most congenital heart diseases is surgery to repair the defect. There are many types of surgery, depending on the kind of birth defect. Surgery may be needed soon after birth, or it may be delayed for months or even years.

Your child may need to take water pills (diuretics) and other heart medicines before or after surgery. Be sure to follow the correct dosage. Regular follow-up with your doctor is important.

Many children who have had heart surgery must take antibiotics before, and sometimes after having any dental work or other medical procedures. Make sure you have clear instructions from your child's heart doctor. It is very important to have your child's teeth cleaned regularly.

Ask your child's doctor before getting any immunizations. However, most children can follow the recommended guidelines for childhood vaccinations.

Expectations (prognosis):

The outlook depends on the specific disorder.

Complications:

Complications of cyanotic heart disease include:

Calling your health care provider:

Call your health care provider if your baby has:

  • Bluish skin (cyanosis) or grayish skin
  • Breathing difficulty
  • Chest pain or other pain
  • Dizziness, fainting, or heart palpitations
  • Feeding problems or reduced appetite
  • Fever, nausea, or vomiting
  • Puffy eyes or face
  • Tiredness all the time
Prevention:

Women who are pregnant should get good prenatal care.

  • Avoid using alcohol and drugs during pregnancy.
  • Tell your doctor that you are pregnant before taking any prescribed medications.
  • Get a blood test early in the pregnancy to see if you are immune to rubella. If you are not immune, you must avoid any exposure to rubella and should get immunized right after delivery.
  • Pregnant women with diabetes should try to get good control over their blood sugar levels.

Some inherited factors may play a role in congenital heart disease. Many family members may be affected. If you are planning to get pregnant, talk to your health care provider about screening for genetic diseases.

References:

Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Zipes DP, Libby P, Bonow RO, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 11th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 65.

Bernstein D. Cyanotic congenital heart disease: Evaluation of the critically ill neonate with cyanosis and respiratory distress. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 423.

Perloff JK, Child JS, AboulHosn JA. Congenital Heart Disease in Adults. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009.


Review Date: 11/21/2011
Reviewed By: Steven Kang, MD, Division of Cardiac Pacing and Electrophysiology, East Bay Arrhythmia, Cardiovascular Consultants Medical Group, Oakland, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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