CARDIOLOGY
EISENMENGER S SYNDROME
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Question
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Infant in the newborn nursery 3 days after birth. Failed the congenital heart disease screening testing performed 3 days after birth. Examination reveals a soft 1/6 systolic murmur at the left lower sternal border, clear lungs, and weak femoral pulses bilaterally, and a capillary refill of 4 to 5 seconds in the lower extremities. Arterial blood gas includes a pH of 7.25, Pco2 of 39 mm Hg, Po2 of 45 mm Hg, bicarbonate of 17 mEq/L (17 mmol/L), and base deficit of-9.Next step:
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Infuse Sodium Bicarbonate
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Initiate prostaglandin E1
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Place and endotracheal tube
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Provide 40% hood oxygen
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Start Dopamine
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Explanation:
Detailed explanation-1: -Diagnostic tests and procedures Echocardiography used during pregnancy (fetal echocardiography) can sometimes be used to help find a congenital heart defect before a baby is born. Electrocardiogram (EKG or ECG) to evaluate the rhythm of the heartbeat.
Detailed explanation-2: -Congenital heart disease may initially be suspected during a routine ultrasound scan of the baby in the womb. Specialist ultrasound, called foetal echocardiography, will then be carried out at around 18 to 22 weeks of the pregnancy to try to confirm the exact diagnosis.
Detailed explanation-3: -The screening process for CCHD uses pulse oximetry.
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