How Early Management Can Improve the Chances of Survival for Congenital

Heart Disease in Infants? : A Case-Report

dr. Vania Essianda, dr. Lourensia Brigita A.P., dr. Gatot Irawan Sarosa, Sp.A (K)

Introduction: In one year, around 50 thousand babies are born with congenital heart disease
now days. The incidence of congenital heart disease (CHD) in newborns is quite high, but
education and treatment regarding this disease are still minimal. Cases of CHD in newborns that
are detected late are the main cause of newborn deaths.1,3

Case Illustration: One-day-old baby born spontaneously by induction of labor from 38 weeks
pregnant mothers with premature rupture of membranes in 5 hours was brought to an Emergency
Room (ER) because of moderate shortness of breath. Apgar score 7-8-9. Already installed with
Continuous Positive Airway Pressure (CPAP). On examination, the baby whimpered with deep
epigastrial retraction, breathing frequency 78x/minute, heart rate 156x/minute, temperature
37.5ºC and the oxygen saturation was 97%. He was programed with D10% 9cc/hour through
umbilical infusion, injection of cephotaxime 2x150 mg and calcium gluconas 2x 1.5cc. Within 4
hours observation, there was oxygen desaturation, peripheral cyanosis and the baby looked weak
so that intubation was done connected to spontaneous mode ventilator. Echocardiography
program, blood gas analysis, routine blood, blood bilirubin and blood sugar were then checked.
The ventilator is maintained for 3 days until the baby was in stable condition.

Discussion: This baby represent moderate to severe shortness of breath that cause low oxygen
saturation and peripheral cyanosis which is a result of cyanotic congenital heart disease. After
given a proper management and treatment and also with early resuscitation, good medical
progress can occur that can stabilize the baby's condition.2,3

Conclusion: We should considered monitoring the possibility of congenital heart disease

especially in infants by observing the risk factors from the mother and if these has not yet known
in the newborn's initial condition, an aggressive treatment should be consider for good outcome.

Keywords: Congenital Heart Disease, Infants.

REFRENCES

1. Suradi R.dkk. 2008. Prevention and Management of Neonatal Asphyxia. Jakarta:

Ministry of Health of the Republic of Indonesia.
2. Lee, A. Mullany, L. Tielsch, J. Katz, J. at all. 2008. Risk Factors for Neonatal Mortality
Due to Birth Asphyxia in Southern Nepal: A prospective, Community-Based Cohort
Study. Pediatrics, 121: e 1381-90.
3. IDAI. Asfiksia Neonatorum. Dalam: Standar Pelayanan Medis Kesehatan Anak. Jakarta:
Badan Penerbit IDAI; 2004.h. 272-276. (level of evidence IV).