Little Hearts Big Love-- CCHD and CHD

February is a busy month of celebrations for matters of the heart.  Over the past few years heart health and wearing red has been in vogue for supporting the cause.  But who are we bringing awareness to exactly?

When you see CHD you might think coronary heart disease, but there is another CHD out there.  Congenital Heart Deformity  and Critical Congenital Heart Deformity which affects approximately 1 out of 120 infants. While some infants are diagnosed prenatally others may not show signs or symptoms until they are discharged home.

New Jersey has taken the lead in helping identify CHD by mandating a simple procedure that is non invasive and part of routine vital signs.  While most nurses wouldn't consider a pulse ox as being so groundbreaking, considering that we seem to use almost without thought.

Is that enough to diagnose CCHD and CHD?   No, it's not, but it is a start!

While some CHD can be suspected related to lowered pulse ox values, it is not the case for all forms of CHD.

Commonly associated CHD linked to low pulse ox include:

• Hypoplastic left heart syndrome

• Pulmonary atresia

• Tetralogy of Fallot

• Total anomalous pulmonary venous return

• Transposition of the great arteries

• Tricuspid atresia

• Truncus arteriosus

It is recommended that the pulse ox be done 24 hours or later, because newborns bodies will often show signs and symptoms several hours or days after birth. For optimal results it is important that the infant now be crying or moving during the reading.  The probe should be placed on the right hand or either of the feet.  
A positive screening includes one of the following

1. SaO2 measurement <90 percent
2. SaO2 measurement <95 percent in both upper and lower extremities on three measurements, each separated by one hour
3. SaO2 difference >3 percent between the upper and lower extremities

http://www.uptodate.com/contents/congenital-heart-disease-chd-in-the-newborn-presentation-and-screening-for-critical-chd#H270523895

While nursing is about medicine it is also about the families of these infants and children who are born with these serious and life threatening conditions.  Below is a link to some amazing stories that truly touch the heart.  http://www.chop.edu/service/cardiac-center/patient-stories/