In this scenario, Catherine’s baby girl has been experiencing episodes of cyanosis and blood gas levels at 60 percent saturation of arterial blood. “Normal arterial oxygen is approximately 75 to 100 millimeters of mercury (mm Hg). Values under 60 mm Hg usually indicate the need for supplemental oxygen” (Mayo Clinic, 1998-2020). Catherine’s newborn is most likely experiencing Critical Congenital Heart Disease (CCHD).
According to the National Institutes of Health, “CCHD prevents the heart from pumping blood effectively or reduces the amount of oxygen in the blood. As a result, organs and tissues throughout the body do not receive enough oxygen, which can lead to organ damage and life-threatening complications. Signs of CCHD include an abnormal heart sound during a heartbeat (heart murmur), rapid breathing (tachypnea), low blood pressure (hypotension), low levels of oxygen in the blood (hypoxemia), and a blue or purple tint to the skin caused by a shortage of oxygen (cyanosis)” (nih.gov, 2020).
Individuals diagnosed with CCHD may have one or more specific heart defects. “Heart defects classified as CCHD include coarctation of the aorta, double-outlet right ventricle, D-transposition of the great arteries, Ebstein anomaly, hypoplastic left heart syndrome, interrupted aortic arch, pulmonary atresia with intact septum, single ventricle, total anomalous pulmonary venous connection, tetralogy of Fallot, tricuspid atresia, and truncus arteriosus” (nih.gov, 2020).
Some of the heart defects associated with CCHD involve structures within the heart itself. “These structures include the two lower chambers of the heart (the ventricles) or the valves that control blood flow through the heart. Other heart defects associated with CCHD affect the structure of the large blood vessels leading into and out of the heart (including the aorta and pulmonary artery)” (nih.gov, 2020).
In this case, Catherine’s newborn daughter seemed fine in her first few moments of life. However, her daughter’s symptoms of cyanosis and low blood gas levels appeared shortly after birth and were significant signs of CCHD. These symptoms were most likely the cause of the echocardiography showing a heart defect. Untreated Critical Congenital Heart Disease (CCHD) can cause a coma, lead to shock, or can even cause death. “Most individuals with CCHD now survive past infancy due to improvements in early detection, diagnosis, and treatment” (nih.gov, 2020).