How should I manage a patient with congenital heart disease who presents with respiratory distress?

When a patient with congenital heart disease presents with respiratory distress, it is crucial to recognise this as a potentially serious complication requiring urgent assessment ⁴, (Judge and Meckler Mshs, 2016). Respiratory distress can be a sign of decompensation in patients with congenital heart disease ⁴, (Judge and Meckler Mshs, 2016). The immediate priority for an Admin is to ensure the patient receives prompt clinical review by a General Practitioner or is referred urgently to secondary care, such as an Emergency Department, depending on the severity of their symptoms ⁴.

• Assess urgency: Respiratory distress, or breathlessness, should be assessed for severity, considering factors such as the patient's work of breathing, oxygen saturation if available, and overall clinical appearance ⁴. For children, signs like increased respiratory rate, nasal flaring, or intercostal recession indicate significant distress ², ⁴.
• Facilitate clinical review: Ensure the patient is seen by a clinician as soon as possible ⁴. This may involve arranging an urgent same-day appointment or advising attendance at an urgent care centre or Emergency Department ⁴.
• Communicate key information: When referring or handing over, clearly state that the patient has congenital heart disease and is presenting with respiratory distress, as this background is critical for clinical decision-making (Judge and Meckler Mshs, 2016).

Managing complications in patients with congenital heart disease often requires specialist input, highlighting the importance of timely referral to appropriate medical services (Judge and Meckler Mshs, 2016).