Adult Cardiac Sonographer Performing Echocardiography to Screen for Critical Congenital Heart Disease in the Newborn

Publication Date: February 28, 2021
Last Updated: March 14, 2022

Key Points

  • A common feature of C-CHD is hypoxemia leading to cyanosis. However, this can be difficult to detect in infants with pigmented skin.
  • Based on recommendations from the Secretary’s Advisory Committee on Heritable Disorders in Newborns and Children, as well as the American Academy of Pediatrics, the American College of Cardiology Foundation, and the American Heart Association, there has been an increased push for routine screening of newborns by pulse oximetry screening in the last decade.
  • A failed POS mandates immediate evaluation for C-CHD, including echocardiography.
  • The purpose of this document is to provide the adult sonographer, who does not typically screen for C-CHD, with the essential information and tools needed to detect C-CHD in newborns and aid in life-saving diagnosis.

Recommendations

  • Centers performing screening echocardiograms in newborns should have a formal relationship with a physician or referral center with expertise in C-CHD.
  • These centers should also have available high-frequency transducers, ECG leads, a mechanism for storage and transmission of images, and a structured two-way communication plan.
  • The interpreting pediatric cardiologist should work with the referring center to develop a method to relay a final report.

Recommendations

  • Adult cardiac sonographers performing neonatal screening echocardiograms should commit to learning non-standard, traditionally pediatric imaging views and sweeps to appropriately identify C-CHD.
  • The interpreting pediatric cardiologist should work with the referring center to develop a scanning protocol to screen for C-CHD.
  • Adult cardiac sonographers should have familiarity with ‘red flag’ findings and urgently communicate those findings, if present, to their pediatric cardiology partners.
6731

Recommendation Grading

Overview

Title

Adult Cardiac Sonographer Performing Echocardiography to Screen for Critical Congenital Heart Disease in the Newborn

Authoring Organization

American Society of Echocardiography

Publication Month/Year

February 28, 2021

Last Updated Month/Year

August 29, 2024

Supplemental Implementation Tools

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Male, Infant

Health Care Settings

Ambulatory, Childcare center, Hospital

Intended Users

Physician, nurse midwife, nurse, nurse practitioner, physician assistant

Scope

Assessment and screening

Diseases/Conditions (MeSH)

D007231 - Infant, Newborn, D006330 - Heart Defects, Congenital

Keywords

screening, echocardiography, Critical congenital heart disease, Community hospital, Newborn nursery, congenital malformations, adult sonographer

Supplemental Methodology Resources

Data Supplement, Data Supplement