**Management of Congenital Heart Disease**

230 Congenital Heart Disease – Selected Aspects

Ropers, D.; Moshage, W.; Daniel, W.; Jessl, J.; Gottwik, M. & Achenbach, S. (2001).

Said, A.; Dearani, J.; Burkhart, H. & Schaff, H. (2010). Surgical management of congenital coronary arterial anomalies in adults. *Cardiol Young*, Vol. 20 (suppl. 3), pp. 68-85. Schmitt, R.; Froehner, S.; Brunn, J.; Wagner, M.; Brunner, H.; Cherevatyy, O.; Gietzen, F.;

Serota, H.; Barth, III, C.; Seuc, C.; Vandormael, M.; Aguirre, F. & Kern, M. (1990). Rapid

Shi, H.; Aschoff, A.; Brambs, H. & Hoffmann, M. (2004). Multislice CT imaging of

Sundaram, B.; Kreml, R. & Patel, S. (2010). Imaging of coronary artery anomalies. *Radiol Clin* 

Takeuchi, S.; Imamura, H.; Katsumoto, K.; Hayashi, I.; Katohgi, T.; Yozu, R.; Ohkura, M. &

Taylor, A.; Byers, J.; Cheitlin, M. & Virmani, R. (1997). Anomalous right and left coronary

Taylor, A.; Rogan, K. & Virmani, R. (1992). Sudden cardiac death associated with isolated

Tuncer, C.; Batyraliev, T.; Yilmaz, R.; Gokce, M.; Eryonucu, B. & Koroglu, S. (2006). Origin

Warnes, C.; Williams, R.; Bashore, T.; Child, J.; Connolly, H.; Dearani, J.; del Nido, P.;

Wilkins, C.; Betancourt, B.; Mathur, V.; Massumi, A.; De Castro, M.; Garcia, E. & Hall, R.

Zeppilli, P.; dello Russo, A.; Santini, C.; Plamieri, V.; Natale, L.; Giordano, A. & Frustaci, A.

Clayton cardiovascular laboratories. *Tex Heart J*, Vol. 15, pp. 166-173. Yamanaka, O. & Hobbs, R. Coronary artery anomalies in 126,596 patients undergoing

coronary arteriography. *Cathet Cardiovasc Diagn*, Vol. 21, pp. 28-40.

echocardiographic screening. *Chest*, Vol. 114, pp. 89-93.

anomalous coronary arteries. *Eur Radiol*, Vol. 14, pp. 2172-2181.

from pulmonary artery. *J Thorac Cardiovasc Surg*, Vol. 78, pp. 7-11.

coronary artery anomalies. *J Am Coll Cardiol*, Vol. 20, pp. 640-647.

angiography. *EuroInterv*, Vol. 4, pp.641-647.

tomography. *Eur Radiol*, Vol. 15, pp. 1110–1121.

method. *Am J Cardiol*, Vol. 65, pp. 891-898.

*Cardio*, Vol. 87, pp. 193-197.

*N Am*, Vol. 48, pp. 711-727.

pp. 428-435.

211-218.

e143-e263.

anomalies in an adult population assessed by computed tomography coronary

Visualization of coronary artery anomalies and their anatomic course by contrastenhanced electron beam tomography and three-dimensional reconstruction. *Am J* 

Christopoulos, G.; Kerber, S. & Fellner, F. (2005). Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed

identification of the anomalous coronary arteries in adults: the "dot" and the "eye"

Inoue, T. (1979). New surgical method for repair of anomalous left coronary artery

artery from the contralateral coronary sinus: "high-risk" abnormalities in the initial coronary artery course and heterogeneous clinical outcomes. *Am Heart J*, Vol. 133,

and distribution anomalies of the left anterior descending artery in 70,850 adult patients: multicenter data collection. *Cathet Cardiovasc Interv*, Vol. 68, pp. 574-585. Virmani, R.; Burke, A. & Farb, A. (2001). Sudden cardiac death. *Cardiovasc Pathol*, Vol. 10, pp.

Fasules, J.; Graham, T.; Hijazi, Z.; Hunt, S.; King, M.; Landzberg, M.; Miner, P.; Radford, M.; Walsh, E. & Webb, G. (2008). ACC/AHA 2008 guidelines for the management of adults with congenital heart disease. *J Am Coll Cardiol*, Vol. 52, pp.

(1988). Coronary artery anomalies. A review of more than 10,000 patients from the

(1998). In vivo detection of coronary artery anomalies in asymptomatic athletes by

**9** 

**Evaluation and Emergency** 

*Bosnia and Herzegovina* 

**Treatment of Criticlly Ill Neonate** 

Emina Hadzimuratovic1 and Admir Hadzimuratovic2

**with Cyanosis and Respiratory Distress** 

*1Department of Neonatology, Pediatric Clinic, University Medical Center Sarajevo, 2Department of Nephrology, Pediatric Clinic, University Medical Center Sarajevo* 

A severely ill neonate with cyanosis and respiratory distress is a diagnostic challenge. The clinician must perform a rapid evaluation to determine whether congenital heart disease is a

The causes of cyanosis can be classified as respiratory, cardic, central nervous system ( CNS )

During a physical examination if an infant appears blue, the following questions need

If the infant has increased respiratory effort with increased rate, retractions and nasal flaring, respiratory disease should be high on the list of differential diagnosis. Cyanotic heart disease usually presents without respiratory symptoms but can have effotless

A murmor usually implies heart disease. Transposition of great vessels can present without

Intermittent cyanosis is more common with neurologic disorders, as these infants may have apneic spells alternating with periods of normal breathing. Continuous cyanosis is usually associated with intrinsic lung disease or heart disease. Cyanosis with feeding may occur

**3.3 Is the cyanosis continous, intermittent, sudden in oncet or occuring only with** 

cause so that potentially lifesaving measures can be instituted.

**3.1 Does the infant have respiratory distress?** 

**3.2 Does the infant have murmor?** 

tachypnea ( rapid respiratory rate without retractions).

**1. Introduction** 

or other disorders.

**3. Evaluation** 

a murmor.

**feeding?** 

immediate answer:

**2. Differential diagnosis** 
