Undiagnosed Congenital Heart Disease in Primary Care (S6 Ep. 47)

When accelerated BSN student Sam Mahaney wanted more practical bedside application of his knowledge of pediatric cardiology, we sat down to discuss the approach to assessment and management of undiagnosed and undifferentiated congenital heart disease from a primary care perspective.  The primary care clinician should be on the lookout for red flags in the history and physical exam that might suggest critical congenital heart disease and screen appropriately.  This episode has helpful perspectives for both the nurse and advanced practice provider. References: Abdurrahman, L., Bockoven, J. R., Pickoff, A. S., Ralston, M. A., & Ross, J. E. (2003). Pediatric cardiology update: Office-based practice of pediatric cardiology for the primary care provider. Current problems in pediatric and adolescent health care, 33(10), 318–347. https://doi.org/10.1016/s1538-5442(03)00137-8 CDC. (2022). Critical congenital heart defects. Retrieved from https://www.cdc.gov/ncbddd/heartdefects/cchd-facts.html. Cleveland Clinic. (2022). Cyanotic heart disease. Retrieved from https://my.clevelandclinic.org/health/diseases/22441-cyanotic-heart-disease Glidewell, J., Grosse, S.D., Riehle-Colarusso, T., Pinto, N., Hudson, J., Daskalov, R., Gaviglio, A., Darby, E., Singh, S., & Sontag, M. (2019) Actions in support of newborn screening for critical congenital heart disease — United States, 2011–2018. Morbity and Mortality Weekly Report, 68:107–111. DOI: http://dx.doi.org/10.15585/mmwr.mm6805a3external icon Mahle, W. T., Martin, G. R., Beekman, R. H., 3rd, Morrow, W. R., & Section on Cardiology and Cardiac Surgery Executive Committee (2012). Endorsement of Health and Human Services recommendation for pulse oximetry screening for critical congenital heart disease. Pediatrics, 129(1), 190–192. https://doi.org/10.1542/peds.2011-3211 Martin, G. R., Ewer, A. K., Gaviglio, A., Hom, L. A., Saarinen, A., Sontag, M., Burns, K. M., Kemper, A. R., & Oster, M. E. (2020). Updated Strategies for Pulse Oximetry Screening for Critical Congenital Heart Disease. Pediatrics, 146(1), e20191650. https://doi.org/10.1542/peds.2019-1650 Puri, K., Allen, H. D., & Qureshi, A. M. (2017). Congenital Heart Disease. Pediatrics in review, 38(10), 471–486. https://doi.org/10.1542/pir.2017-0032 Strobel, A. M., & Lu, l. (2015). The Critically Ill Infant with Congenital Heart Disease. Emergency medicine clinics of North America, 33(3), 501–518. https://doi.org/10.1016/j.emc.2015.04.002