Title: Cyanotic Congenital Heart Disease (submitted by Adeleke Oni, MD)<br/>Author: Mimi Lu<br/><a href='http://umem.org/profiles/faculty/185/'>[Click to email author]</a><hr/><p>
Cyanotic (right to left shunt) Congenital Heart Disease (CHD) lesions can be easily remembered with the 1,2,3,4,5 method.</p>
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1- Truncus Arteriosis (ONE trunk)</p>
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2- Transposition of the Great Vessels (TWO vessels flipped)</p>
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3- TRIcuspid Atresia</p>
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4-TETRAlogy of Fallot</p>
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5- Total Anomolous Pulmonary Venous Return (TAPVR=5 words/letters)</p>
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A few other important DUCTAL-DEPENDENT lesions: Coarctation of the Aorta, Hypoplastic Left Heart Syndrome, and Pulmonary Atresia.</p>
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Patients present to the emergency department within the first week of life in severe distress, including hypoxia, tachypnea, and hypotension. The above cyanotic CHD all reflect DUCTAL-DEPENDENT lesions, meaning they need a widely open PDA (which closes in the first week of life) to maintain sufficient oxygenation for viability.</p>
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These patients will not survive without timely intervention with prostaglandin (PGE1), so be sure to initiate this life-saving medication as soon as possible! Side effects include apnea…be prepared to intubate your neonate!</p>