Critical Congenital Heart Disease (CCHD) screening is a routine test performed on newborns. This screening aims to identify serious heart conditions that may not be apparent at birth. Early detection through this simple procedure can lead to timely medical intervention, significantly improving a newborn’s health outcomes.
Understanding Critical Congenital Heart Defects
Critical Congenital Heart Defects (CCHDs) are structural heart problems present at birth. These defects can prevent the heart from effectively pumping blood or reduce oxygenated blood circulation. When tissues and organs do not receive enough oxygen, it can lead to organ damage. CCHDs are a leading cause of infant illness and death, affecting about 1 in 4 babies born with a heart defect.
Babies with CCHDs may appear healthy initially, but can rapidly develop severe symptoms within days or weeks, often requiring emergency care and surgery. Early diagnosis allows for prompt treatment, preventing disability or death.
The Screening Process
CCHD screening is performed using a bedside test called pulse oximetry, which estimates the oxygen levels in a baby’s blood. This painless test involves placing a small sensor on the baby’s right hand and on one foot. The sensor shines a red light through the skin to measure oxygen in red blood cells.
The screening is usually conducted after a baby is 24 hours old, or before hospital discharge. Waiting at least 24 hours helps reduce the chance of false-positive results. The entire process takes only a few minutes.
Interpreting Screening Results and Next Steps
The results of CCHD screening are typically available immediately. A “pass” or normal result indicates that the baby’s oxygen saturation levels are within a healthy range, specifically 95% or greater in both the right hand and foot, with minimal difference. This suggests a low likelihood of CCHD, and no further immediate testing is usually needed. However, a passed screen does not rule out all heart conditions, so ongoing pediatric check-ups remain important.
An “abnormal” or “fail” result means the baby had lower than expected oxygen levels (e.g., below 90% in either limb, or saturation between 90-94% with a greater than 3% difference between hand and foot). An abnormal result does not automatically confirm a CCHD diagnosis, as other factors like breathing problems or infections can also cause low oxygen. In such cases, the healthcare provider arranges for immediate follow-up testing.
Follow-up typically includes a repeat pulse oximetry screen, an echocardiogram (an ultrasound of the heart), and other tests such as an electrocardiogram or chest X-ray. These evaluations help determine the cause of low oxygen levels and identify if a CCHD is present. If a CCHD is confirmed, a pediatric cardiologist is consulted to develop a treatment plan, often involving surgery or other procedures early in life.