“Blue baby” is a term used to refer to a new born with blue tinged skin due to a lack of oxygen in its blood. It is usually caused by the presence of congenital heart defects (CHD), such as the Tetralogy of Fallot, tricuspid atresia, or the hypoplastic left heart syndrome. Conditions such as these can be life-threatening in most cases if not treated soon after birth.
Currently, surgical treatments are the most common. The first successful operation for congenital heart defects was performed on November 29, 1944 by a surgeon named Alfred Blalock at the Johns Hopkins Hospital. A pioneer in his field, he ushered in an era of tremendous progress in the treatment of the so-called “blue babies”.
Image Source: Popperfoto
Up until the 20th century, most babies born with moderate to severe CHD died in infancy or during childhood. But advancements in treatment, such as the ability to perform open-heart surgery, has gradually increased the life expectancy of these infants through the years. Recently, a research study performed at the Shalgrenska Academy in Sweden showed that over 90% of the individuals in the study, who were operated on for congenital heart defects as infants, were alive 20 years post-surgery. Additionally, the mortality rate within 30 days of such a surgery is currently at less than one percent. For the first time in our history, the number of adults who are living with CHD has become equal to the number of children living with CHD. As the number of adults with CHD is rising, physicians are increasingly daunted by the complexity of this condition. An individual with CHD who had a surgery performed in childhood to repair his heart defect may require additional procedures as an adult. He may also experience long-term complications in adulthood, such as valvular dysfunction or arrhythmias. It is becoming increasingly clear that in order for such patients to receive optimal care, their adult and pediatric healthcare professionals must collaborate.
Currently, only about a 100 US cardiologists are sufficiently trained to treat CHD in adults. Despite the significant successes in the treatment of pediatric CHD patients, the understanding of how to appropriately treat adults with CHD is still very limited.
In order to improve the care for such patients, the focus is slowly shifting towards multi-disciplinary approaches. According to the most recent ACC/AHA guidelines, improved outcomes for Adult CHD patients can be achieved by extension of physician caregiving by clinical care associates such as Physician Assistants (PA) and Nurse Practitioners (NP) with the expertise in the management of such patients. These PAs and the NPs will not only help physicians recognize these patients but will also ensure an increased survival for people with CHD by ensuring that these patients get high-quality optimal care.
Feature Image Source: baby by irisWphotography
