Heart

Question 1

Purpose of screening

Answer 1

Detect neonates with congenital heart disease

Question 2

What is the incidence of CHD

Answer 2

6.3 in 1000 in England
8 in 1000 live births
Critical CHD accounts for 15-25% of these and leading cause for morbidity and mortality

Question 3

Range of CHD

Answer 3

Critical CHD
Major CHD includes defects not as critical but requiring invasive international in the first year of life
Less major CHD enquiring intervention but not n the first year of life
Nn significant CHD which is unlikely to require intervention

Question 4

Risk factors

Answer 4

Family history of CHD
Trisomy
USS suspected
Consanguinity
Maternal exposure to viruses -rubella
Diabetes
Smoking
Alcohol
Substance misuse
Drug related teratogens

Question 5

Observation

Answer 5

Tone
Colour
Size and shape of chest
Symmetry of chest movements
Respiratory distress
Link with feeding

Question 6

Palpation

Answer 6

Femoral and brachial pulses
Capillary re full time
Position of apex
Vibratory sensation - thrill

Question 7

Auscultation AND WHEREE

Answer 7

Presence of a murmur
Systolic/dystolic
Lous/quiet

Aortic
Pulmonic
Tricuspid
Mitral
Mid scapulae

Question 8

Screen negative

Answer 8

No anomalies found
Baby referred to healthy child programme
Repeat 6-8 weeks at nipe

Question 9

Screen positive

Answer 9

A antenatl diagnosis or PN suspicion of trisomy 21
Tachypnoea at rest
Espisodes of apnoea
Recession, nasal flaring intercostal
Central cyanosis
Visible pulsations
Absent or weak femoral pulses
Murmurs and or extra heart sounds

++ refer for neonatal review, time sensitive within 24hrs depended on severity

Question 10

Health education for parents

Answer 10

Baby sleep and not interested in feeding
Baby is pale or blue
Increased RR or sucking in of skin between ribs
Clammy r cold skin
= call 999