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Critical congenital heart disease — DCH MCQ

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HardNeonatologyCritical congenital heart diseaseDCH

A 2-day-old baby has a soft systolic murmur but is pink and feeding. Oxygen saturations are 91% in the right hand and 87% in the foot, with mild tachypnoea. What is the most important red flag?

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Correct answer: C — Differential low oxygen saturations

Differential low saturations in a newborn suggest possible critical congenital heart disease and require urgent paediatric assessment. A soft murmur alone can be benign, but low pre- and post-ductal saturations are not. The pearl is that pulse oximetry can detect important duct-dependent lesions before collapse.

Reference: NIPE screening programme; NICE CKS Heart murmurs in children