Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, 682041, India.
Indian J Pediatr. 2020 May;87(5):365-371. doi: 10.1007/s12098-019-03163-4. Epub 2020 Jan 28.
Congenital heart disease (CHD) has been one of the most important contributors to neonatal mortality in the western world for the past 2 decades. With improvement in basic neonatal medical care in most parts of our country, the traditional contributors to neonatal mortality such as birth asphyxia and infections have reduced in numbers. This has hence thrust greater focus on CHD. Facilities with capability to diagnose and intervene on neonates with critical CHD are available in most states. Refinements in surgical techniques and advances in post-operative care have ensured that most neonates with critical CHD can undergo surgical or interventional procedures with very low mortality and can be expected to survive to adulthood with a reasonable quality of life. Unrecognized critical CHD could however result in death in the neonatal period. Focus has hence shifted towards sensitizing pediatricians about timely recognition of neonates with CHD. In this article, authors discuss the presentation and initial stabilization of neonates with CHD and attempt to provide practical solutions which can aid early diagnosis of CHD in the Indian scenario.
在过去的 20 年中,先天性心脏病 (CHD) 一直是西方世界新生儿死亡的最重要原因之一。随着我国大部分地区基本新生儿医疗保健水平的提高,出生窒息和感染等传统新生儿死亡原因的数量有所减少。这使得人们更加关注 CHD。大多数州都有能够诊断和干预重症 CHD 新生儿的设施。手术技术的改进和术后护理的进步确保了大多数患有重症 CHD 的新生儿可以接受手术或介入治疗,死亡率非常低,并有望在成年后过上有一定生活质量的生活。然而,未被识别的重症 CHD 可能会导致新生儿期死亡。因此,重点已转向使儿科医生关注及时识别患有 CHD 的新生儿。本文作者讨论了患有 CHD 的新生儿的临床表现和初步稳定,并试图提供在印度情况下有助于早期诊断 CHD 的实用解决方案。