Cyanotic heart diseases - Diagnosis and treatment

- [Voiceover] I don't know if you've noticed this, but out of all the congenital heart diseases, the ones that are cyanotic begin with the letter T. Cyanotic heart disease. We have tetralogy of flow. We have TAPVR. I always have to take a second to say that. Total anomalous pulmonary venous return. We have truncus arteriosus. Truncus, where we have lack of differentiation between the two great vessels. We have transposition, where the two great vessels are plugged in the opposite way that it should be. And we have tricuspid atresia. See, all these begin with a T. This makes it much easier to remember. All these ones makes the baby blue. The diagnosis of all these diseases can be summarized in one word. And that's echo, or echocardiogram. Basically, an ultrasound of the heart. Echocardiogram. This is done as early as when the baby's in the mommy's belly and we can see exactly what a heart defect they have. And what struck me when I was on a month of rotation on pediatric cardiology, is that we learn these different abnormalities separately, but rarely do people have just one. I feel like almost every baby I saw had two or three, so we always have to echo to see exactly where each chamber of the heart is. Exactly how each vessel is plugged in. So the echo really gives us a 3-D picture of what we're dealing with. And it's usually done more than once, and repeatedly after the baby's born to see how things are changing and progressing. And in treatment, these days, it's surgery, surgery, surgery. Pediatric cardiology I feel like works very closely with surgery. Now whether or not someone needs surgery depends on their anatomy through the echo and also through their physical exam. Aside from surgery, there are certain medicines that we can use before or after the procedure to help our cause. A medicine usually is not enough on its own to correct these defects, but it can help. For example, we can have inotropic drugs that help the heart work a little harder. Or we can decrease the resistance that the heart is working against by dilating our vessels, giving them a greater diameter, and so the heart can have an easier time getting blood through. Things like that. And lastly, of course, the pediatric cardiologists still do use their stethoscopes to monitor the patient's progress. So they listen. Usually there's a lot of murmurs involved. And the change in the murmurs can tell us how a particular defect is progressing. Cause they can change from day to day. And one of the most important things that tells us exactly what the heart is doing, is to monitor the oxygen saturation. These patients are usually almost permanently stuck to a probe that tells us what percentage of oxygen is in their blood. Which can tell us how well the heart is functioning, how much blood is going to the lungs versus the body. Before or after surgery, we always care about the oxygenation. There's not much more I can say about this, because the treatment for cyanotic heart disease is almost always different on a case by case basis. But in general, remember that they begin with Ts, we need to echo to see the structure, usually there's some sort of surgery done in addition to medicines, and we care about how the heart is sounding and what percent of oxygen is in their blood.