CCHD Screening Flashcards¶
Screening Protocol¶
Q: When should CCHD screening be performed? A: After 24 hours of life or before discharge if earlier Tags: cchd, timing, high-yield
Q: Where is pulse oximetry measured for CCHD screening? A: Right hand (pre-ductal) AND either foot (post-ductal) Tags: cchd, technique, high-yield
Q: Why is the right hand used for pre-ductal measurement? A: Right subclavian arises before ductus; left hand may be post-ductal depending on anatomy Tags: cchd, technique
Q: What are the PASS criteria for CCHD screening (2025)? A: SpO2 ≥95% in BOTH right hand AND foot, AND difference ≤3% Tags: cchd, criteria, high-yield
Q: What SpO2 value indicates immediate failure (needs echo)? A: <90% in ANY measurement Tags: cchd, criteria, high-yield
Q: What SpO2 values require retest in 1 hour? A: 90-94% in either location OR >3% difference between pre- and post-ductal Tags: cchd, criteria
Q: How many retests are allowed in the 2025 algorithm? A: Only 1 retest (changed from 2 retests in previous algorithm) Tags: cchd, 2025-update, high-yield
Target Lesions¶
Q: What are the 7 primary target lesions for CCHD screening? A: HLHS, Pulmonary atresia (intact septum), TOF, TAPVR, TGA, Tricuspid atresia, Truncus arteriosus Tags: cchd, target-lesions, high-yield
Q: What is the sensitivity of CCHD screening? A: 50-76% - cannot rule out CCHD with negative screen Tags: cchd, sensitivity, high-yield
Q: Which CCHD lesion is most commonly missed by pulse ox screening? A: Coarctation of the aorta Tags: cchd, missed, high-yield
Q: Why is coarctation missed by CCHD screening? A: Ductus may still be open at screening, allowing adequate lower body perfusion Tags: cchd, coarctation
Secondary Detectable Conditions¶
Q: What secondary cardiac conditions may be detected by CCHD screening? A: Coarctation, Ebstein anomaly, critical AS, critical PS, interrupted aortic arch, DORV, single ventricle variants Tags: cchd, secondary-lesions
Non-Cardiac Causes of Failed Screen¶
Q: What non-cardiac conditions can cause failed CCHD screen? A: Pneumonia, TTN, meconium aspiration, PPHN, sepsis, CDH Tags: cchd, false-positive
Q: What should be done after a failed CCHD screen? A: Echocardiography + evaluation for non-cardiac causes (CXR, CBC, blood gas) Tags: cchd, workup
Special Circumstances¶
Q: How does high altitude affect CCHD screening? A: Higher false positive rate; some centers use lower threshold (93%) Tags: cchd, altitude
Q: Can CCHD screening be done before 24 hours? A: Yes - if early discharge needed; higher false positive rate due to transitional circulation Tags: cchd, timing
Q: What is the specificity of CCHD screening? A: ~99.9% - very few false positives Tags: cchd, specificity