Ever wonder what CCHD meant on a newborn discharge summary? Learn about how we screen for Critical Congenital Heart Defects in newborns (and which ones we miss!) in this episode.

This episode was written by Dr. Lidia Park and Dr. Tammy Yau with content support from Dr. Heather Siefkes. Drs. Lidia and Tammy take full responsibility for any errors or misinformation.



Key Points:

• Critical Congenital Heart Defects (CCHD) screening looks for heart defects that can be life threatening in infancy such as coarctation of the aorta, single ventricle defects like hypoplastic left heart syndrome, Tetralogy of Fallot (ToF), pulmonary atresia, total anomalous pulmonary venous return (TAPVR), transposition of the great arteries (TGA), and tricuspid atresia (TA).

• CCHD screening does not detect atrial septal defects (ASD), ventricular septal defects (VSD), or atrioventricular septal defects (AVSD)

• CCHD screening is performed by checking the pulse oximeter of the right hand and either foot of a newborn. SpO2 less than 90% is an automatic fail. SpO2 differences of 3% or more or SpO2 91-95% should be repeated twice before counting as a fail. Failed CCHD’s should be followed up with an echocardiogram.

Sources:

• CDC: Clinical Screening and Diagnosis for Critical Congenital Heart Defects | Congenital Heart Defects (CHDs) | CDC
• BMC Pediatric 2021, Jullien S. Newborn pulse oximetry screening for critical congenital heart defects. doi:10.1186/s12887-021-02520-7

• Pediatrics 2011, Kemper AR, Mahle WT, Martin GR, et al. Strategies for implementing screening for critical congenital heart disease. doi:10.1542/peds.2011-1317