Summary
About blue baby
Risk factors and causes
Signs and symptoms
Diagnosis methods
Treatment methods

Risk factors and causes of blue baby

There are a number of different types of heart defects that can cause the baby’s bluish tint (cyanosis). These heart defects include the following:

• Tetralogy of Fallot. A condition that involves the “tetralogy” of the following four elements:

   

  • Ventricular septal defect(VSD). A hole in the wall (septum) between the heart's two lower chambers (the ventricles). The VSD creates a pathway between the right and left ventricle. This results in blood flow between the two chambers.

  • Pulmonary stenosis. A narrowing (stenosis) of the pulmonic valve. This narrowing decreases the amount of oxygen-poor blood from the right ventricle that can squeeze through the narrowed opening and travel through the pulmonary artery to the lungs. Thus, there is a decreased blood flow to the lungs.

  • Hypertrophy (enlargement) of the right ventricle. An enlargement of the muscle tissue of the right ventricle due to pulmonary obstruction (as described above).

  • Displaced or deviated aorta. Most of the oxygen-poor blood in the right ventricle cannot go through the VSD into the left ventricle (because the pressure in the left ventricle is too high), and cannot squeeze through the pulmonary valve and travel to the lungs as it should. This forces the blood to travel up through the displaced aorta that lies directly over the VSD. Therefore, the aorta is receiving both oxygen-poor blood from the right ventricle and oxygen-rich blood from the left ventricle, and carries this mixture to the rest of the body. Because the body is receiving so much oxygen-poor blood, the skin of the child often has a bluish tint (cyanosis).

• Transposition of the great arteries (TGA). A congenital heart defect (present from birth) in which blood from the left (red, oxygen-rich) and right (blue, oxygen-poor) sides of the heart is mixed because of the reversal of locations of the “great arteries”: the aorta and the pulmonary artery. In this defect, the aorta leaves from the right ventricle (carrying oxygen-poor blood to the body) and the pulmonary artery leaves from the left ventricle (carrying oxygen-rich blood right back to the lungs). The baby may develop cyanosis because oxygen-poor blood, full of waste products from the cells and organs, is let back into the body before oxygenation in the lungs can take place.

• Total anomalous pulmonary venous return (TAPVR). A condition in which the pulmonary veins that bring oxygen-rich blood back from the lungs to the heart are not connected to the left atrium. Instead, these veins drain into the right atrium. Thus, the oxygen-rich blood is going right back to the lungs, leaving oxygen-poor blood to travel to the body. Oxygen-rich blood must pass through a hole in the septum to reach the left ventricle (which can then pump the blood to the rest of the body).

• Tricuspid atresia. A condition in which the tricuspid valve is completely closed, which impedes or totally obstructs blood flow between the right atrium and the right ventricle. As a result, the blood flow from the right ventricle to the lungs is reduced, which means there is less oxygen-rich blood to circulate through the body.

• Hypoplastic left heart syndrome (HLHS). A condition in which the left side of the heart (including the aorta, the aortic valve, the left ventricle and the mitral valve) is not totally developed. As a result, blood flow, pumping and most other cardiac functions are severely compromised. This can lead to cyanosis because the left ventricle is not adequately pumping enough oxygen-rich blood to the body.

• Critical pulmonary stenosis (a severe narrowing of the pulmonary valve) or pulmonary atresia (its complete closure). Normally, this valve allows blood to flow from the right ventricle to the lungs. When severely narrowed or closed, less blood flow reaches the lungs, leaving less oxygen-rich blood available to circulate through the body.

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Signs and symptoms of blue baby

Aside from the bluish tint (cyanosis) of the skin, nails, lips, tongue or other parts of the body, signs and symptoms of a blue baby include the following:

Easily fatigued, especially during crying spells and at feeding time
Low tolerance for exercise or extra exertion
Shortness of breath (dyspnea) and/or rapid breathing
Fainting (syncope) or collapsing
Difficulty eating, breathing or sucking
Poor weight gain
Slow growth or other physical retardation
Heart murmur, as detected by a physician

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